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Request Auto Acupuncture Care
Fill out the form and Sarah will be in contact within 5 business days
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What's your name? First and Last
What's your name? First and Last
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What’s your phone number?
What’s your phone number?
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Can Sarah text you?
Can Sarah text you?
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Yes
No, call only please
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Were you in a car accident and looking for Acupuncture to help heal your injuries?
Were you in a car accident and looking for Acupuncture to help heal your injuries?
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Are you working with an attorney for your car accident?
Are you working with an attorney for your car accident?
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No
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If yes, who is your attorney and what is their phone number/contact info?
If yes, who is your attorney and what is their phone number/contact info?
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If no, are you interested in Sarah referring you to an attorney?
If no, are you interested in Sarah referring you to an attorney?
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Who are the other providers you are seeing for your auto accident care? Name and contact number
Who are the other providers you are seeing for your auto accident care? Name and contact number
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There are a few locations Sarah could see you at - which would you prefer?
There are a few locations Sarah could see you at - which would you prefer?
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Westminster, CO
Aurora, CO
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What are the issues that you are dealing with that you would like addressed?
What are the issues that you are dealing with that you would like addressed?
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What questions do you have for Sarah before we get started on treatment?
What questions do you have for Sarah before we get started on treatment?
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How did you hear about Sarah?
How did you hear about Sarah?
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