Online Consultation

Your Name (required)

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Home Address

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Phone Number

Problem Subject (required)

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Any other medical condition

Attach e-xray

Patient Video Testimonials:

youtube-vid

youtube-vid

youtube-vid

youtube-vid

youtube-vid

Attach the following if possible– Recent x-rays if available –
– A list of medications you are presently taking -Any medical condition that may be of concern, such as diabetes, high blood pressure, artificial heart valves or joints, rheumatic fever, etc.; or if you are on heart medications, aspirin therapy, anticoagulant therapy, etc.