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 *

Date of birth *

Phone *

How did you hear about us?

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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

Women's Bio-Identical Hormone Replacement Therapy

Men's Low Testosterone Treatment

Thyroid Disorders

Gut Health & Digestion

Food Sensitivity Testing

Cortisol & Stress Response

Toxins & Heavy Metal Exposure

Advanced Cardiac Panel & Cholesterol Testing

Genetic Testing, MTHFR

Autoimmune Conditions

Biggest Obstactles to 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

Additional Message

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