Medical Intake Forms

Initial Consultation

Schedule your medical intake (initial review) and then secure your confidential doctor visit online.

Enter MD Intake

A secure HIPPA compliant medical intake form for USAMCA (US, Canada, Mexico patients).

Medical Care

You and your doctor establish an initial treatment program customized for you.

Please click on the link below.

Enter your email address.

An email confirmation and password will be sent to you, so you can login into the website and fill in the confidential HIPPA compliant online intake form.

CLICK HERE FOR ACCESS TO INTAKE QUESTIONNAIRE.