Medical Tint Exemption Intake

Name
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Do you agree to opt-in for text message notificaiton for: Updates from your healthcare provider, Shipping updates or Office staff notifications

Medical Tint Exemption

What are you trying to use a medical tint exemption to help with?
How many vehicles are you looking to obtain an exemption for
Please assure that if not approved you will be granted a full refund
(If you are leasing your car or financing, please contact your lessor or bank to obtain the title number)
Billing Address
Is your shipping address the same as your billing address
$0.00
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