Functional Medicine Intake Form

To start getting control of your health care problem please fill out the form below. Functional medicine will get to the root cause of your problem. This requires a complete history for the doctor to understand your condition and how to move forward. Please be as accurate  and as through as possible. After the doctor reviews you will be contacted  by staff within a day or two. Not all cases are accepted. We only accept cases we are confidant can help.