Stop Smoking Registration

Register & Pay $35 for Office Consultation

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  • Once you make this payment complete the second half of the form that asks details about your lifestyle problem. All information is confidential and only seen by Dr. Smith.
  • WE DO NOT RETAIN CREDIT CARD INFORMATION!
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    Supported Credit Cards: American Express, Discover, MasterCard, Visa
     

WEIGHT LOSS

PAIN & MIGRAINE

STOP SMOKING

ANXIETY & DEPRESSION

ALCOHOL & DRUGS