New Patient Waiting List - Dr. James Huang (www.drjameshuang.com)
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First and Last Name *
Phone Number
What is the best way to reach you? *
When is the best time to contact you? *
What is your availability for an appointment? (Day and Time) *
Email Address *
Why do you want to see Dr. Huang? *
On a scale of 1 to 10 how much pain are you experiencing? *
How did you hear about Dr. Huang? *
Which location would you like to visit? *
Where do you live? (City, State, Country) *
How effective is wearing a mask to stop the spread of COVID-19? *
Not effective
Very effective
Do you have any chronic health issues that you are dealing with currently? *
Dr. Huang is very active on Instagram, do you use instagram? If you do, please share below: *
Thanks for your request! Looking forward to connecting soon!
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