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Client Intake : General
This is a generalized client intake for The XKN Clinic. Some questions such as your bio will be repetitive, This is legality and for your safety. 
Name *
Email *
What is your main concern? 
Where did you hear about us?  *
1 point
Medical History *
1 point
Required
This is your area to ask me any questions. Or let me know about current health of your skin :) / body  *
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