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FOR ONE-TIME CONSULTS

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Please answer every question. It is ONE CONSULT PER PERSON, so you should only answer the questions only for you (or the patient if you're ordering the consult for a loved one). 

 

When you're done and you submit the form, we will evaluate your answers, prescribe appropriate medication, and call in your medication. Then we will notify you by email and by text.

Registration

To register, please take the time to fill out the information below.

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