Patient Form
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*For any medical procedure, patients respond to treatment differently, hence each patient’s results may vary.
**In case of a life threatening emergency, immediately call 911.
***Information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content contained on or available through this site is for general information purposes only.
****By using this website and sending us your information, you are giving us permission to contact you by electronic and non-electronic means. We also track the conversions and collect user data to improve marketing.
*****If you have an impairment that is covered by the American Charter of Rights and Freedoms, American Human Rights Act or Accessible America Act, and you wish to discuss potential accommodations related to using this website, please contact us.
**In case of a life threatening emergency, immediately call 911.
***Information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content contained on or available through this site is for general information purposes only.
****By using this website and sending us your information, you are giving us permission to contact you by electronic and non-electronic means. We also track the conversions and collect user data to improve marketing.
*****If you have an impairment that is covered by the American Charter of Rights and Freedoms, American Human Rights Act or Accessible America Act, and you wish to discuss potential accommodations related to using this website, please contact us.
