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WMS Internet Concierge Practice Form (1-A)

Please complete the form below by July 20, 2017 for your purchase of the July 2017 - July 2018 Internet Concierge Practice program with Dr. Karen Leggett.


(Note: the form is highly encrpyted for security; it may take a moment to appear.)


[powr-form-builder id=bb73a6dc_1500078434]

 You will receive a credit card charge receipt by email, usually within 24 hours of submission.