Virtual Appointment Request with Tabasum M.D.
Thank you for reaching out. Please answer all questions.
Please also note we will do our best to accommodate your date. But Dates are subject to their availablilty
First and Last Name
Instagram Handle (ex: @Tabasum)
City and State of residence? (I am licensed to practice in New York State)
Date of Birth
What treatment are you interested in?
What is your FIRST requested Date and time? (ex: March 31. 2pm EST)
Contact Phone Number
Send me a copy of my responses.
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