PLEASE READ:  This site is NOT for patients with Head or Body Trauma (automobile, motorcycle, bicycle, slip and fall, blunt head trauma,assault, MMA, boxing, or any sports history) .

Your First Steps to Diagnosis and Treatment:
1. Fill out the New Patient Intake form below. Step I
2. After submitting the Intake Form you will be redirected to Step II: New Patient Information Packet (NPIP).  
3. Once you have sent us the NPIP someone in our office will call you. 
4. After the call we will charge your credit card and start the process of scheduling your laboratory testing. Incomplete documents can slow or stop the process.  
5. Access Medical Laboratory will arrange for you to go to a walk-in clinic for a "blood draw" or an at home blood draw.   If you are close to my office you can schedule an appointment for us to draw your blood in the office.
6. Once blood is drawn it can take from 7-10 days to get the results and another  7-14 days for a comprehensive 4-paged report to be written and emailed to you. 
7. When you get your report you are instructed to arrange for a Skype, RingCentral, or a Phone Call to review your results. There is no additional fee for this consultation and review of your results.
8. The call can last from about 60 minutes so we can review the report and the proposed treatment protocol.  
9. During this conversation we will arrange for the best means to start your treatment protocol; if you are in California or Florida we can start your program immediately. Otherwise, we will need your physcian's participation.  
     Therefore, please make sure we have all the contact information for your physician; Name, Address, Phone, Email, and Fax. 
    

Patient Intake Form
First name:
Last name:
Date of Birth:
 * required
Occupation:
Address1:
Address2:
City and State:
 * required
Zip_Code:
 * required
Home Phone:
Cell Phone:
EMail:
 * required
How Referred?:
Who Referred:
I want this Program:
Medical Issue:
Medical Survey
I am on
Hormone Replacement Therapy
What HRT?:
I have
Allergies.
I am on
Medication.
My Meds are
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