Client Application Form

Win-win relationships start here

To honor both your time and hard earned money, we ask all interested clients to fill out this form. 

 

Please ensure you have read through the available client services, policies  and IMPA Code of Ethics.

Please fill out this application as honestly as possible. This form is strictly confidential and will be used to determine client eligibility and if accepted, for rendered services. 

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Are you currently under a medical doctor's care?
Are you currently taking any prescription medication?

Dr. Cristy Cali 2019 All Rights Reserved.

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