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Patient Contact Form

Contact Dr. G via this form.

[contact-form to=’info@gingergarner.com’ subject=’Message from Patient Contact Form’][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Phone #’ type=’text’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’What is this about?’ type=’radio’ options=’This is about an existing appointment.,I%26#039;d like to schedule an appointment.,This is about something else.’/][contact-field label=’Message’ type=’textarea’ required=’1’/][/contact-form]