Photos

Photo Uploads

Photos help us to better understand your needs, and will expedite your journey. Thank you for your trust! This form is HIPAA Compliant and Confidential.
Name*

First NameLast Name
Email
example@example.com
What are your concerns?
The more detail the better!
Your photos will upload much faster if you select a medium file size, which you can easily do on an iphone. For detailed instructions on optimal photos, click HERE.
Driver's License*

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Your driver's license or other form of photo ID Cancelof
Photo 1*

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Please attach a photo that best shows your area of concern. Cancelof
Photo 2

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Additional photos help us to understand your goals. Cancelof
Photo 3

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Cancelof
Photo 4

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Photo 5

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Thank you for your trust! Cancelof
Because of file size and HIPAA security, photos can take up to 30 seconds to upload. Please be patient, your photos will go through securely! You can also select a smaller file size for faster uploads.
Should be Empty:

Photo Uploads