By clicking the “Submit” button, you agree to our website terms and conditions, privacy policy, and authorize a representative of NMCI Medical Clinic to reach you at the appointed contact information you provided. Please do not discuss, submit or transfer Personal Health Information (PHI) or personally sensitive information through this contact form. The information submitted will be delivered via email, not through a secured messaging interface. NMCI Medical Clinic is not responsible and will not be held liable in respect to the safety, delivery, privacy, confidentiality or reliability of information sent through this form.