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Anomaly Lactation Services Appointment Request
After you fill out this appointment request, we will contact you to go over details and availability. Questions? Contact me at
tiffany@anomalylactation.com
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Email
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Your email
Are you a new or existing client?
I am a new client
I am an existing client
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Do you want virtual or in home service?
*
In home available in the DMV/NoVa area only. Virtual available everywhere.
In my home
Virtual/telehealth
What is your primary reason for seeking lactation care?
*
Your answer
How urgent is your issue?
Extremely urgent-need to be seen within 1-2 days
Urgent-Need to be seen within 3-4 days
Not Urgent- Need to be seen within 5 day to 1 week
Scheduling requests
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What days & times would work best for you over the next week?
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Your name
*
Your answer
Phone number
*
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E-mail
*
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Preferred contact method
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Phone
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Questions and comments
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