Name * Who is the appointment for? First Name Last Name Phone * (###) ### #### Date of Birth MM DD YYYY Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country What services are you interested in? * Medical Weight Loss IV Vitamin Drips Trigger Point Injections Other Injections for Muscle/Joint Pain Consult for Medical Marijuana Certification Other How soon are you looking to book? * As soon as possible! 1-2 weeks Within the next few months More than 6 months away I'm not sure Message Additional Contact If the contact person is someone other than the person who will be receiving services, please provide your name, phone number and email address below. Thank you! Your request has been submitted. Someone will be in touch shortly! If you need to reach us you can call/text us at 631-500-5925 Get in touch. We’re here for you. Hours of OperationMonday-Sunday8:00 am – 8:00 pm(varies per location and service)