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Meet & Greet Form

© Live More Simply, Inc 2020 -- This website is fully protected by law. All Rights Reserved.

5454 La Sierra Drive, Suite 201 Dallas, TX 75231 - drr@livemoresimply.com  - In-Person, Cellphone and Video Sessions for COVID-19 Anxiety

Schedule your FREE, 30 min, Meet & Greet

If we have no openings, we can add you to our waiting list

Patient Name (First, Middle, Last)*

Patient Birth Date*

Patient Email*

Patient Phone*

I am interested in * (drop down)

 

Please note: We may not be able to respond until Sun eve or Mon morning.

After submitting your form response, you may email drr@livemoresimply.com to check your status. Be sure to read the message below after you click send.

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