Please enable JavaScript in your browser to complete this form.Full Name *Your Email *Phone Number *Your Message *Send Message Have Any Queries? Wish to get a consultation or a quick checkup to identify the kind of treatment you need? Just send me a message, text, or give me a call.– Karin Cross crosskarin6@gmail.com (805) 607-0992 Ventura County and around FORMS Patient Consent Form Patient History Form