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Blood Glucose Log Sheet Phone 866-333-0686 Fax 800-716-9586 Please complete all sections A B and C A Patient Information B 30 Day Time Frame Patient Name Patient Date of Birth Start Date / / End Date MM DD YY By completing this log the patient or Authorized Representative certi es that the blood glucose testing information below is complete and accurate.
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866 - This is the area code.
333 - This is the three-digit prefix.
0686 - This is the last four digits of the phone number.
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