New Patients

Your intake

A thorough intake before your first visit means we spend our time together on you — not on paperwork. It's confidential, encrypted, and takes about 15–20 minutes.

Before you begin

What to have handy

The more complete a picture I have before we meet, the more of our visit we can spend on what actually matters to you. It helps to have a few things nearby before you start:

  • Your medication and supplement bottles — names, doses, and how often you take them.
  • Any recent labs, imaging, or records you'd like me to see (you can upload them at the end).
  • Your pharmacy name and location.
  • A quiet 15–20 minutes — you can be as detailed as you like in the open-ended sections.
Your privacy

This form opens in our secure, encrypted, HIPAA-compliant system — your health information is protected and goes directly to the clinic. Please don't send medical details by regular email or text. In an emergency, call 911.

Payment & insurance

A note on payment so there are no surprises: the clinic is direct-pay and does not accept insurance. HSA payments are welcome. After your visit we will gladly provide a superbill — an itemized receipt you can submit to your insurance company — and many plans reimburse part of the cost under their out-of-network physician benefits. Every plan differs, so a quick call to your insurer about out-of-network reimbursement will tell you exactly what to expect.

Ready when you are

The secure intake opens in a new window. You can save and return if you need to step away.

Begin Secure Intake →

Prefer to talk to a person first, or having trouble with the form? Reach the clinic here → or call 317-410-9978.