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How did you hear about us?*
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Reason(s) for Visit*
Medical Weight Loss
Women's Bio-Identical Hormone Replacement Therapy
Men's Low Testosterone Treatment
Thyroid Disorders
Gut Health & Digestion
Food Sensitivity Testing
Cortisol & Stress Response
Toxins & Heavy Metal Exposure
Advanced Cardiac Panel & Cholesterol Testing
Genetic Testing, MTHFR
Autoimmune Conditions
What are your BIGGEST obstacles to achieving your health goals?
Financial
Time - too busy
Lack of knowledge
Too tired
Current medical treatment is not working well
Other
What are you looking for most in a health care provider? (choose all that apply)
Listens to me
Looks at the big picture (holistic approach)
Collaborates with me to help me make the best health decisions for my circumstances
Looks for the root causes of my medial problems instead of just addressing my symptoms
Do you have any questions that you want to be sure we address when we speak?
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