Medical Review Form (Current Clients)

  • E.g. OHSU/Walgreens
  • E.g. Dr. John Smith
  • E.g. Dr. Jane Smith (Cardiologist)
  • Name of PrescriptionPer DayDosage30 or 90 day refill 
    E.g. Atorvastatin/once/40mg/30
  • Max. file size: 256 MB.
    Current Medication List

Contact Us.

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 601 East 22nd Street
WA 98663

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8:30am - 5:00pm
Monday - Friday

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Contact Us

Vancouver, WA (866) 606-8093



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All health insurance sold is processed through the licensed entity of Baldwin Risk Partners


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