Get the up-to-date lyme tap form 2012-2024 now

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To apply send a completed application along with requested documentation to the fax number above. If approved you may be reimbursed for up to 75 of your out-of-pocket costs of testing from a qualified CLIA/Medicare approved laboratory of your choice. Funds are limited are available on a first-come first-served basis. Children under 18 years of age are given priority. The intention of this program is to help as many patients in need as possible. It is not intended to cover insurance deductibles ...

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