Glacier Cross - Relief from Neck Pain and Relief from Back Pain

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Neck Pain	Back Pain

Glacier Cross® Order Form

You must have a perscription to get Pronex™ or Homestretch®, if you would like help getting started, please fill out the form below.

Are you interested in Pronex™?
Are you interested in Homestretch®?
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Name of Clinic or Facility
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Mailing Address (Line 2)
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Home Phone
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How would you prefer to be contacted?
Do you currently prescribe traction?
Have you ever prescribed the Pronex™ or Homestretch®?

Is there any specific issues you face when prescribing the Pronex™ or Homestretch®?
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