Welcome!

Please complete the following medical history form so we can order your lab work and schedule your appointment with one of our board-certified providers once your results are received.

Important Information:

If you complete this form after regular business hours or on the weekend, you will receive your lab order form and instructions on the next regular business day.
We require relevant laboratory work prior to your initial consultation and every 6 months thereafter. Your lab work is included with your signup and monthly membership at no additional charge (unless you request labs beyond our standard comprehensive panel).
After we review your information and receive your completed lab results, we will ensure you have everything needed before your provider visit.
Once you have your initial consultation, you are under no obligation to continue services if you choose not to. If you decide to continue, your monthly membership will begin after your initial consultation.
We cannot provide prices on medications until you are evaluated by a provider, go over labs and have a discussion with your provider about what is appropriate for you moving forward.
Your monthly membership covers comprehensive hormone labs every 6 months, all follow-up appointments, and your provider reviewing your refill assessments every 60 days and processing your refills. Medications, additional labs, and other testing are billed separately. We typically prescribe medications in 60-day increments.
No contracts — You may cancel at any time as long as you provide us with 48 business hours notice.
All paid membership fees are non-refundable.

We look forward to welcoming you to the No Limits Family!

Clinic Policies:

We use Quest Diagnostics exclusively for all lab work.
We are a cash-pay only clinic. We do not accept insurance, bill insurance, provide letters of medical necessity, or complete any insurance forms.
You are welcome to use your HSA card, but we cannot guarantee that your specific HSA plan will cover our services.
We only work with FDA-regulated compounding pharmacies in the United States who ship to your home and we do not call in prescriptions to local pharmacies.
All care is completely individualized and based on your specific labs, history, goals and needs.

I understand that I am agreeing to receive SMS and/or email messages from No Limits Medical, LLC that may contain information about appointments, updates or marketing. These messages may be sporadic and local carrier rates may apply for you as a user. You can opt out of messaging from No Limits Medical, LLC at anytime by replying STOP to any messages or by contacting us at [email protected]. You also understand that my provider may recommend hormone therapies. Hormone therapies CAN affect fertility (both positively and negatively). If fertility is a concern for you then you are acknowledging that you must be sure to bring this up with your provider and discuss this issue so that we have help you try to mitigate fertility concerns one way or the other. Testosterone CAN decrease fertility for men and IT MAY BE PERMANENT. If you want to be sure to maintain your fertility, you agree to discuss this with your provider. *

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