• * Please fill the form with as much information as possible to help us schedule a time for you. * If you want a quicker response, leave a phone number and we will call you instead of emailing. * If you want to schedule a school screening, please call us.
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  • Name*
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  • Email*
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  • Phone#*
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  • Requested Time*
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  • Requested Date*
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  • How May We Help You?
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  • Please choose one service below for each person. Do not choose both for one person.
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  • Treatment-If you have seen bugs or eggs or a very high possibility. (a head check may be performed if requested)
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  • Treatment*How many people
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  • Evaluation- Your not sure if you or someone else has head lice or just need a check for peace of mind.
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  • Evaluation (head check)*How many people
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  • If we find lice or eggs, do you want us to treat immediatley?*
    yes
    no
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  • Anything else we should know about that will help us?*
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