Clinic/Healthcare provider name
ABN
Address line 1
Address line 2
Suburb
State
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NSW
NT
QLD
SA
TAS
VIC
WA
Postal code
Clinic email address
Clinic phone number
Practice nurse names
Add Doctors
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1
2
3
4
5
6
Urologist/doctor name
Prescriber ID
Urologist/doctor name
Prescriber ID
Urologist/doctor name
Prescriber ID
Urologist/doctor name
Prescriber ID
Urologist/doctor name
Prescriber ID
Urologist/doctor name
Prescriber ID
*
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Contact Information