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Request an Appointment

Please fill out the details on this form and a team member will contact you to schedule your appointment. Same day appointments may be available - for fastest response, please submit this form then call or text our office at (770) 467-3975.

Full Name*

Email*

Phone*

Date of Birth*

How did you hear about us?*

Appointment Preference:*

First available (usually same week, possibly same day)

Weekday mornings

Weekday afternoons

Friday evenings 5-8pm (limited appointments)

Saturdays (limited appointments once monthly)

Telehealth

Reason(s) for Visit:*

Medical weight loss

Hormonal concerns related to periods, mood, libido

Hormonal concerns related to energy, metabolism, weight gain

Brain fog, poor memory, difficulty concentrating

Fatigue or sleep issues

Gut health, digestion

I would like to optimize my overall wellness

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 medical problems instead of just addressing my symptoms

Do you have any questions that you want to be sure we address when we speak?

Please verify your request.*