Schedule Appointment

1
Getting Started

To make this process quick and easy, have your ID, insurance card, and pharmacy information nearby (if applicable). If you need assistance at any point, our support team is available via live chat.
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Time
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Hour
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Minutes
PM
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PM
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Returned to complete form? step 1
Yes
No
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Email Address* This field is required.List email where appointment info can be sent
example@example.com
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Mobile Phone Number* This field is required.Please list number that receives text messages
Please enter a valid phone number.
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Are you a new or existing client?* This field is required.
New Client
Existing
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For existing clients, have you been seen in the last 6 months?* This field is required.If yes, we will connect you directly with an intake specialist via our website live chat instead of completing this form.
YESNO
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Thanks for letting us know you are an existing client who has been seen in the last 6 months!

After you submit this form we will open up a live chat for you so we can connect you to one of our intake specialists.
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Get Page URL
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Unique ID
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Should be Empty: