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Step 1: Fill out Quick Intake
Step 2: Choose Appointment Time
Step 3: I’ll Call you

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  • Basics

    Thanks for contacting me to set up a phone consult. Please fill out this short intake questionnaire so that I can get a better idea of who you are and how I can help you. Fields with an asterisk are mandatory. THIS IS AN ENCRYPTED FORM. All data other than your contact information will be encrypted before being sent to us. Only authorized users on our end will be able to view your sensitive data.
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