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Therapy Image

You’ll receive one gift card for every friend you refer who becomes a new SourceMedical customer.

1) Register Yourself.
Your Name*
Title
Name of Facility*
Address*
City*
State*
Zip Code*
Phone Number*
Contact Email*


2) List a friend in need.
Friend's Name*
Title
Name of Facility*
City*
State*
Phone Number*
Contact Email*
YES, I gave them a heads up about SourceMedical

 

*Once your referral is a signed client of SourceMedical, your gift card will be shipped to the provided address. In the event the same referral has been given more than once, the person who sent the referral first will receive the gift. You may fill out multiple forms for additional referrals. For questions regarding this and other promotions, please call Myong Shipman at 800-245-8093 or email therapy@sourcemed.net and mention promo code 1871.

SourceMedical
Attn: Sales & Marketing
100 Grandview Place, Suite 400
Birmingham , AL 35243
Phone: 866-245-8093
Fax: 205-449-9777

Email: therapy@sourcemed.net
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