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Application for evaluation

  • YOU ARE REQUIRED TO PROVIDE CORRECT INFORMATION
  • In order for doctors to make a correct evaluation, you must provide all required data. We have made the form as simple and convenient as possible so that you do not waste your time on unnecessary actions

  • EVALUATION TAKES 420 SEC
  • PAYMENT AFTER APPROVAL
  • ALL DATA IS STRICTLY CONFIDENTIAL
California

Please select the symptoms or conditions that you look for evaluation:

Please write any other information that might be useful to the doctor:




How did you hear about us ?


  • Total: 39$



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