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  • 815 South Utica Avenue, Tulsa, OK 74104
  • 918.584.8607
  • 815 South Utica Avenue, Tulsa, OK
  • 918.584.8607

You must have an active email address to fill out this application. If you would like to print one off and mail it in here is the link to the PDF, Member Application 17 .

Please complete this form in its entirety. After completion you will be emailed a form that needs to signed by your physician and faxed back to us at 918-584-8646 or emailed to info@tulsacenter.org

General Information

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