Curio Medical Intake

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Estimated time: 2 minutes

Thank you for your interest in Curio!

Please provide information about yourself and patient. If you have any questions please don't hesitate to call (415) 941-0579 or email us at support@joincurio.com.

Your patient's privacy is a priority and all intake and treatment records will be kept confidential. They will be maintained with the same precautions as ordinary medical records.

We look forward to supporting your patient.
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Referring clinician informationPlease include your first, last name, and available contact information below.
First name
Last name
Clinic Name
Your Email
Your Phone Number
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Patient informationPlease include patient's full name and at least one method to contact them.
First name
Last name
Patient Email
Patient Phone Number
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Please share relevant medical history and why you're referring this patient.
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