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 SERVICE REQUEST 

This web form is used to determine if we can service your call. We will get back to you promptly, usually within 20 minutes. Can't wait? Call us! We will be happy to go over your options.

TYPE OF SERVICE
LEVEL OF URGENCY
SERVICE REQUESTED
PERSON SUBMITTING REQUEST

 TERMS AND CONDITIONS 

NO EMERGENCY

in emergency, please contact your nearest emergency medical services (911) immediately

LIMITED SCOPE OF PRACTICE

We are not a primary or urgent care physician’s practice: our services are limited to treating adult patients with pain- and stress-related conditions. Ultimately, some patients - especially those with multiple and/or complex health problems - may be served better by a more traditional full-service medical practice.

NO MEDICAL ADVICE

This communication is solely to inform you of our currently available services and providers, does not constitute medical advice, does not create a duty of care or a doctor-patient relationship, and is not a guarantee of medical care.

ELECTRONIC COMMUNICATIONS

By submitting this request, you are agreeing to communicate with us electronically through unencrypted (unsecure) means (web, email, and text) thus waiving our obligations under HIPAA with respect to secure communication. If privacy is a concern, please do not continue and call instead.

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