By submitting this form, I acknowledge and agree that:
- The 1-on-1 Breast Cancer Coaching service provides educational and informational responses only.
- This service does not constitute medical advice, diagnosis, or treatment and does not create a physician–patient relationship.
- I will consult my own healthcare provider for medical evaluation, diagnosis, or decisions.
- I consent to the use of my provided information solely for verifying my payment and delivering my educational response.
Breast Cancer Coaching Submission Form
Phone number
555-555-5555
Our address
Street Name Zip Code, Country