Contact

Ready to Reach Out?

Step 1 of 2

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Patient First Name *

Patient Last Name *

Patient D.O.B. *

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Primary Email *

Primary Contact # *

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Condition of Interest *

Decision Stage

Message *

Enter the correct answer: *

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Please check yes to acknowledge The C.U.B.E. is only establishing a wait list at this time *

Yes, I understand by sending this message that only wait list spots are available.

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Location and Schedules

Headquarters located in Southern California

Hours: By scheduled appointment only