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Consultation Form

Please take a moment to fill out the form and we will contact you as quickly as we can. The more information you can provide, the better we can assist you without delay.

How would you like us to contact you?
Which services are you interested in with Dr. Miller? (Check all that apply.)
Choose any option that describes your current claim:
If you are claiming a mental health condition (such as PTSD, anxiety, depression), do you have a current diagnosis for this condition in your medical/mental health records?
Yes
No
I'm not sure
Not applicable
If you are claiming a physical condition caused by your service-connected mental health condition (such as migraines caused by PTSD), do you have a current diagnosis for this condition in your medical records?
Yes
No
I'm not sure
Not applicable
How did you find us?
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