|
Email Sign-Up Form
In order for us to maximize the services we provide to as an important member of the Larimer County Medical Society we need to ensure that we have the proper email address for you. This email will only be used for LCMS purposes and we will not redistribute it for any purposes.
For the purposes of the LCMS we would like to get the best email to get the information directly to you in a timely fashion. We understand that for some that will mean sending it to your personal email address or for others going through an office administrators email account. Whatever you determine to be the best route will be the route we follow.
Email Address:________________________________________________________________________
This Email is my: Business Personal Office Admin. Other_______________________
__________________________ ____________________________ _____________
Name (Please Print) Signature Date
Please Return to the Address Below or Fax to Number Below! Thanks for helping us to serve you better!
5256 Promontory Circle, Windsor, CO 80528 Telephone (970) 674-7512 Fax (970) 674-7513
|
