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Blue Mountains
Blue Mountains

Appointment Request

Please feel free to call me or fill out the form below to inquire about making an appointment.  Please note my email should NOT be used to communicate clinical information.  If you choose to contact me via email, be aware that email is NOT a secure nor confidential means of communicating.  Therefore, the privacy of communication cannot be guaranteed.  Email is reserved for general questions only.  Any actual appointment scheduling is to be finalized on the phone with me for the first appointment.

If you need Emergency Medical or Psychiatric Care, please Dial 911 or go to the nearest Emergency Room for assessment.

Thank you




We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

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By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

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Helpful Forms

Click here to view and print forms for your appointment.

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