Patient aged 18-20 Verification

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Phone Number

Doctor's Name

Doctor's Clinic Name

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Recommendation Expiration Date

Recommendation #

New patients 18-20 years old,Upload OR email (info@kroniccandy.com) A Clear Copy Of Your Drivers License Or CA ID (required)

Upload OR email (info@kroniccandy.com) A Clear Copy Of Your Dr. Recommendation (required)

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