If you have a question that requires a yes or no answer, or is clarifying directions from a previous visit and I did not send you instructions via email, please email me for clarification. If you have new concerns, ongoing conditions, or questions that require a detailed response, an appointment will be necessary. This can often be arranged within several days, depending on schedule availability. We will answer messages during business hours and strive to reply promptly. If we are unavailable for any extended reason such as vacation, you will receive an automated reply.