Apply Online

It doesn't take long to provide our staff your patient information to be verified online. Are you asking yourself is this real and legal? Yes we are and yes it is! Don't be shy and take a couple minutes to fill out the form below and someone will contact you shortly.

Your message matters to us and we thank you in advance for you choosing The Strainbank.

Pre-Verification Form

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Note:  Your patient information always remains private & secure with management personnel only.