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+ 1 541-754-3010

Online Forms

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+ 1 541-754-3010

Online Forms

Here are some important forms you to review and complete prior to your appointment with one of our physicians or provider.

  • Screening Checklist for Visitors
  • New Patient Enrollment Form
  • Medical History Form
  • Online Doctor Appointment Form
  • Psychiatric Evaluation Form
  • Quick Emergency Contact Form
  • Blood Donation Form
  • HIPAA Privacy Restriction Questionnaire
  • Medical Release Form

I help people overcome negative thinking, anxiety & self-doubt so they can live with confidence clarity and lasting peace

hola@peterjulius.com

Request an Appointment

Our Services >

  • Stop Smoking
  • Negative Thinking
  • Self-Confidence & Self-Worth
  • Anxiety & Worry
  • Stress & Burnout
  • Letting Go of the Past
  • Stop Smoking
  • Negative Thinking
  • Self-Confidence & Self-Worth
  • Anxiety & Worry
  • Stress & Burnout
  • Letting Go of the Past

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  • Home
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  • Services
  • Book an Appointment
  • Request an Appointment
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  • About Me
  • Services
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  • Request an Appointment

Contacts >

Address:

Phone:

Opening Hours:

Online via Zoom / Google Meet

 (+34) 616 77 88 52

Mo-Fr: 07:00-23:00h

Address:  

Torremolinos – Malaga – Andalusia – Spain

Phone:

 (+34) 616 77 88 52

Opening Hours:

Mo-Fr: 07:00-23:00h

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Online via Zoom / Google Meet

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hola@peterjulius.com

I help people overcome negative thinking, anxiety & self-doubt so they can live with confidence clarity and lasting peace

United Kingdom

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