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    Tell your medical team!

    Let them know better breast screening is important to you.
    • Just answer the questions in the form below
    • In the next step, you'll see a customized message.
    • If that message isn't quite right, that's OK. You'll be able to edit it.

    Let's get started!

    Please enter your first and last name.
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    Please share the name of the practice or organization where you'd like to see Koning Vera in the future?

    Please let us know if you'd like us to leave a placeholder for your personal story.


    Please make a selection so we know who you'd like to write to.
    Please tell us the name of the person you're sending your message to.




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