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Resources
Medical Release Form
If you wish to join Real Family Medicine please complete this form and mail it to your current medical provider to get your records released.
Membership Agreement
Please review, sign and return our Membership Agreement.
Privacy
Patient consent for use and disclosure of protected health information.
506 Elevator Street • Farmersville, IL
Hours: M, T, Th, and F 9:30 a.m. to 4:30 p.m.
Mailing Address: PO BOX 198 • Farmersville, IL 62533
(appointments, insurance, general medical)
traci@realfamilymedicine.com
(217) 960-9087
(billing, new patients)
annie@realfamilymedicine.com
(217) 600-2808
(217) 269-5888
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