Required field combination not finding your info. Please review and try again.
* Required Fields
By submitting an email address, you agree and confirm that the email is personal to you, is not an employer-provided email and that you take sole responsibility to limit the disclosure of the content of your email.You further acknowledge and agree to receive communication from MDS or its affiliates about your account in electronic format to the email you provide, which can include personal information about you.MDS will still take precautions to secure any health information in accordance with any applicable laws and its agreement with any specific health care provider. This consent will apply to all accounts MDS holds in your name.
The only requirements for electronic communication are that you have a valid email address and an ability to view standard PDF documents. You take sole responsibility to update MDS of any change tin your email address. You may withdraw this consent, make changes to your contact information or request a paper copy of your information by email to email@example.com.If you do not agree, please do not enter your email address.This is not a required field.
< p > By submitting your phone number, you are agreeing to have MDS or its affiliates, contact you at that number via prerecorded or artificial voice messages, text messages, video or automatic dialing devise, which you understand could result in charges.You are not required to provide your phone number here if you do not agree to these terms.You may revoke your consent at any time by contacting our office. You further acknowledge you will not submit any number that is not private to you or has limitations on its contact.