New Patients

We look forward to seeing you! To help us serve you better, please print the following forms and bring them with you on your first visit.   We work with your other physicians to help you to feel like yourself again.

New Patient Profile

Patient Policies (Cancelation Policies UPDATED)

Medicare Exemption Contract ( *ALL patients need to sign even if under 65 years old**)

Informed Consent for Treatment

Informed Consent for Sex Hormone Replacement 

Informed Consent for Testosterone Replacement Therapy

HIPPA Patient Consent Form

Prices, Insurance & Testing

The first new patient appointment is 1 hour long and $400, return visits are $185 for 30 mins and $370 for 1 hour. We recommend hour long return visits if multiple issues are being addressed. At the end of each visit, you will be given a "superbill" to submit to your insurance company for reimbursement. Since we have opt-ed out of Medicare, they will not provide reimbursement.

For testing, a blood work form will be given to you for testing of thyroid, vitamins, minerals, lyme, cardiac biomarkers, etc. Blood work is done at stand alone lab centers and covered by your insurance. Speciality testing, (that a regular lab cannot do) including hormone testing is separate and not included in the initial appointment fee. For more information on the testing we offer, please click here. 

UPDATED Cancelation Policy:

Canceling or rescheduling within 3 business days of visit, no charge.

Canceling or rescheduling within 2 business days, 50% charge of visit fee.

Canceling or rescheduling within 1 business day, 100% charge of visit fee. 

 

Click here to download the basics on Thyroid & Bioidentical Hormones

For current patient resources, click here.

Appointment Request Form

If you don't already have an appointment, simply fill out this form with your contact information and we will get back to you as soon as possible. (If you prefer, you can call us instead: 1-540-542-1700)