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First name* Last name* Email address* Telephone* Therapy* Pain Relief Facial Rejuvenation (Cosmetic Acupuncture) Quit Smoking Allergies Women's Health Other Conditions Herbal Consultation Date & time 12 am 01 am 02 am 03 am 04 am 05 am 06 am 07 am 08 am 09 am 10 am 11 am 12 pm 01 pm 02 pm 03 pm 04 pm 05 pm 06 pm 07 pm 08 pm 09 pm 10 pm 11 pm 00 05 10 15 20 25 30 35 40 45 50 55 Please provide additional date and time that works for you along with brief description of your symptoms. We will get back to you within 24 hours.*

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