TMS Inquiry Form

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TMS Inquiry Form

Please complete the required sections on behalf of the patient. GenHealth staff will reach out to them to discuss any questions they may have regarding TMS therapy.

* Indicates required question

First Name *

Your answer

Last Name *

Your answer

Phone Number *

Your answer

Email

Your answer

Insurance *

Choose

Aetna

Blue Cross/Blue Shield

Cigna/Evernorth

Tricare

TriWest/VA/CHAMPVA

Self-Pay

Other - Please comment below

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