Update Voice and Picture For Frequencies
Name
*
First Name
Last Name
Birthdate
*
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Month
-
Day
Year
Date
Email
example@example.com
Chief Concern and/or Main Symptom(s)
Email
example@example.com
Needs to be a current Image of Yourself (headshot).ONLY YOU IN THE PHOTO PLEASE. Accepted file types include pdf, jpg, jpeg, png.
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Browse Files
Drag and drop files here
Choose a file
Cancel
of
Use the record button below to record a 15 second Audio File of yourself saying [your full name + a-e-i-o-u + your top concern]
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Submit
Should be Empty: