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A.M.I.I. East
Academy of Minimally Invasive Implantology
COVID-19 Impact Statement - V.2
This form has to be completed and submitted.
First Name
Last Name
• How many patients approximately are you seeing a day vs. the number before Covid-19?
• Is your production steadily increasing?
• Are you adding or replacing equipment in your practice that you need to re-open?
•How does this current purchase help the practice better function?
•Do you have a plan and/or the means to make payments if another shut occur?
I declare that the info I’ve provided is accurate & complete
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Please don't forget to send a copy of your driver license to
finance@AMIIamerica.org
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