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No medical details on this form. We’ll talk on the call. Not for emergencies (see box below). Telehealth in TX & CO · In person in Frisco, TX.

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Fees from $275 follow-ups · Evaluation $1,175 · Full fees

Your privacy. We only use this to contact you about scheduling. Privacy Policy · Notice of Privacy Practices

I agree to the Privacy Policy and to be contacted about this request. I understand fees are private-pay (out-of-network). I understand a member of the medical staff may complete the free consultation and may call or email me.