What type of allergies affect you?
Grass Dust Pet dander Pollen
Are you experiencing asthma symptoms?
Yes No
What treatments have you tried?
Over-the-counter Prescription meds Natural remedies None
How often do you seek medical help?
Monthly Yearly Rarely
What is your preferred contact method?
Email Phone call SMS
Would you like to schedule a consultation?
Yes No
All set, how can we reach you?
Name
Email
Phone
(Details here)
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    Tailored treatment plans!

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