First Name is required.
Last Name is required.
Address is required.
City is required.
State is required.
Zip Code is required.
Phone is required.
Email is required. A valid email is required.
OFFICE LOCATION * MIAMI LOCATION CORAL GABLES LOCATION HOMESTEAD LOCATION Please select a location.
Reason for appointment is required.
If you have any further questions, please do not hesitate to contact us.
Cancellation Policy: The patient has 24 hours prior to the appointment to cancel or change the appointment. In the event that patient does miss the appointment, we reserve the right to charge the patient for the consultation. The 24 hour cancellation policy is a courtesy to the doctors at The Selem Center and their time.
