Executive Medical Consultants

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GIFT CERTIFICATES


 

Print the forms below for recipient. These forms must be completed

and signed by the recipient, spouse, and any dependent over 18 covered on insurance. 

  Mail or fax to
 526 Canton Rd. Akron, OH  44312.
330-315-2554 (fax)
 
 
 
PAYMENT: We accept PayPal, Visa, Mastercard, Discover, American Express, as well as debit cards.
 

 
PLEASE NOTE: Gift membership will not be active until we receive the above completed forms.