By completing this form and checking the box below you consent to be contacted by Dr. B. J. Ferraccio, LLC / Dr. F. via the information you entered and you further understand and provide your consent that Dr. Ferraccio may email your provided address, send a text message to your provided number, or call and leave a voicemail when he attempts to contact you. Your completion of this form also serves as acknowledgment of your understanding and acceptance that, at this time, it is not known precisely when Dr. F. will be able to contact you, and that subsequently, you understand and agree that should you require immediate care either now or while waiting to speak with Dr. F., you are hereby advised to seek out treatment from another mental health professional, to contact a mental health crisis center (dial or text 988) or in the case of an emergency / urgent need, to contact emergency services or travel to your nearest emergency center.
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