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Verify Patient Email Address
Company (Found at top left of your statement/bill)
Acute Surgical Care
Burn and Reconstructive Centers of Colorado
Burn and Reconstructive Centers of Texas
Burn Centers of Florida
Joseph M Still Burn Centers Inc
Burn and Reconstructive Centers of Idaho
Southeast Idaho Surgical Group
Account Number (Listed on top right of your bill)
Patient Name (If different than person paying)
Patient Date of Birth (mm/dd/yyyy)