Do you have a Primary Care Provider

We require all of our patients to be under the direct care of a Primary Care Provider (PCP) who manages day-to-day routine and urgent care.

Yes

No

Name *

First Name

Last Name

Phone

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Client Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What services are you interested in?

Aquarian Medicine Consultation

Energy Medicine

Mindful Movement