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This form is for general inquiries only. Do not submit Protected Health Information (PHI) or any other confidential information through this inquiry form. This includes, but is not limited to, medical history, diagnoses, and insurance details. We cannot guarantee the security of information submitted via this form. Please call our office to schedule an appointment or to learn how to properly submit PHI or other confidential information to us. Submitting an inquiry through this form does not establish a physician-patient relationship. In case of a medical emergency, dial 911.

By submitting an inquiry, you agree to these terms.