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Fill out the form below and we will get back to you within 1-2 business days to discuss your needs and scheduling.

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Are you located in Florida?

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Do you consent to NP Carmen reaching out to you by phone for a brief screening call?

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Note: Submitting this form does not establish a therapeutic/medical relationship.

Please note: This form is not HIPAA-compliant and is not a secure patient portal. Do not share sensitive personal health information. Submitting this form does not guarantee an appointment. We will contact you when space becomes available.

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