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Get Generic Attending Physician Statement Form

A member of the ING family of companies ING Life Claims: PO Box 1548, Minneapolis, MN 55440; Toll-Free: 888-238-4840 ING Life Claims Overnight Address: 20 Washington Avenue So, Minneapolis, MN 55401 Your future. Made easier. The completed form must be sent to the above address. The patient is responsible for the completion of this form without expense to the insurance company. INSURED/PATIENT INFORMATION Insured/Patient Name Birth Date Group Number Address ZIP State City Group Informat.

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