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Thank you for your interest in an appointment! We prefer you to fill out the request form here and submit it to Lexi add your screening information. Thank you in advance! I prefer to be contacted through EMAIL initially. 1. Full name: 2. Appointment requested day. time and how long? Who would you like to see? 3. Do you have any references? If so please list their name, phone number or website email.We need a known provider as your reference. 4. Contact phone number where you can be reached and best time to call. 5. If you dont have provider references we will need your employer, a phone number where we can verify. 6. Your email address where you can be reached. 7. Where are you located? Please understand we need this information for our safety! Everything will be handled discreetly and professionally!