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First Name

Last Name

Phone Number *

Email Address *

Which of the following licenses do you hold in Texas:

Licensed Paramedic

RN Nurse

Nurse Practioner

Physicans Assistant

None, I have others that will hold the certifications and do the work

How soon would you like to start you IV/Aesthetics business? *

1-4 weeks

5-8 weeks

3+ months

ASAP

Already Open

Not sure

How do you plan to run your business:

Rent a location

Mobile

Both

What do you feel is your biggest obstacle to starting your own business?

What do you need help with?

Billing Related Question
Medical/Protocols Related Question
Prescription Weight Loss Consulataion
Supply/Medication Order
Something Else
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