DHARMATOLOGY

DHARMA: act virtuously towards others

We are offering significantly reduced rates for people who are uninsured or financially unable to afford laser repair of damaged skin whether from disease, such as lupus, or trauma, such as burn scars. You may refer your candidate patient by filling in the form below.

Your Name

First Name

Last Name

Your Email Address

Your Phone Number

Candidate Patient Name

First Name

Last Name

Candidate Patient's Date of Birth

Your Relationship to Candidate Patient

Brief Description of the Condition Needing Treatment

DHARMATOLOGY

DHARMA: act virtuously towards others

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