Prostate | Enlarged Prostate | Male Sexual Health

Contact Form

If you are asking a question or reporting a problem with this site, please fill in enough data on the form below so I can answer you. Specifically, your first name, email address, and of course, your question in the comments area is required. All other information is optional.

If you want a return phone call, I will also need your City, State (for the time zone), and your phone number.

This is a secure, encrypted communication. If you are already on my client list or you are a new client, you can use this form to transmit credit card information, mailing address, or other items securely at your option. 

Please Note:  We fully respect your privacy and do not share information with anyone. Data entered on this form is transmitted via a secure connection. All inquiries will be answered via email within 24 hours. 

You can also contact me directly via email, or via telephone at 239-652-0421 during regular work (9am-6pm EST) hours.

Note: Regular email is unsecured. Use only this form for credit card information.

Name (* First, Last):      
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Your questions, comments and/or special instructions.


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