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Confirmation Page
Please fill out the form below to confirm you appointment
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Phone
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Email
Email
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Check which method you would like to use for the virtual Visit
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Phone call
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Purpose of the Visit
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Weight Loss
Office(Sick) Visit
Virtual (video) Visit
Confirm Date
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Working Days: Monday - Saturday
Confirm Time
9 AM - 11 AM
11 AM - 1 PM
1 PM - 4 PM
4 PM - 5:45 PM
4 PM - 6:45 PM (Thur & Fri)
After hours
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Follow Up Visit
Sick Visit
Weight Loss
Additional Services
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Total
$ 0.00
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