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Patient Intake Form

Welcome to our Patient E-Z Intake Clinical History Form. The information you fill in will be sent directly to our office, speeding up your initial office visit. Also, do share this link with someone who needs immediate care. Again, I welcome you to our office and we are excited to help you with your wellness and recovery journey. Call us at 915-850-0900 if you request assistance. God Bless & Great Regards. Dr. Alex Jimenez

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