THE PURPOSE OF THIS FORM IS FOR MY SAFETY, I DO NOT KEEP YOUR PERSONAL INFORMATION AFTER OUR APPOINTMENT. I'M SURE YOU FILL FIND MY PROCESS EASY AND NON-INVASIVE.

PLEASE CALL ME AFTER YOU FILL OUT AN APPOINTMENT REQUEST TO CONFIRM I RECEIVED THE EMAIL. I NEED EITHER A CURRENT REFERENCE FROM A KNOWN PROVIDER OR YOUR PLACE OF BUSINESS AND COMPANY PHONE NUMBER.

DISCRETION IS OF THE UTMOST IMPORTANCE, I WOULD NEVER REVEAL THE PURPOSE OF MY CALL WHEN CHECKING AN EMPLOYMENT REFERENCE I WILL SIMPLY CHECK THE PHONE NUMBER AND NAME OF THE BUSINESS.