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Please fill out the form below to make an appointment. This form is secure and all information is encrypted to protect your anonymity. We respect your privacy and use the information you provide us to better serve you. We do not sell or trade your personal information with any third parties.

*MUST READ THIS LINK IF YOU PLAN TO VISIT OUR CLINIC IN GEORGIA




Today's Date:
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PATIENT INFORMATION:
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LOCATION PREFERENCE

Charlotte, NC
3220 Latrobe Dr. 28211
Raleigh, NC
1604 Jones Franklin Rd 27606
Augusta, GA
2903 Professional Parkway 30907
*MUST READ THIS LINK IF YOU PLAN TO VISIT OUR CLINIC IN GEORGIA

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IF THERE IS A PROBLEM WITH SCHEDULING AT THESE TIMES PLEASE CALL THE CLINIC AT 1-888-562-7415 AND WE WILL GLADLY HELP SUIT YOUR NEEDS.

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