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How this works

Are you a doctor retiring soon? Fill out this form below and we will be in touch within 5-7 business days.

I'm a retiring doctor...

First and Last Name

Phone

EMR Name

Your Email

My office knows I'm retiring * Required

Yes

No

Practice Name if Different

Provider NPI number

I'm interested in record storage * Required

Yes

No

I'm interested in getting a retirement consultation * Required

Yes

No

Expected Date of Retirement

Thanks for submitting!

Email

support@ineedmyrecords.com

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