Become a Patient

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Become a Patient

Become a New Patient

Thank you for your interest in the BioHealth Wellness Center – Where Wellness Begins! New Patient Consultations are $95, however, if you decide to move forward with an initial examination or testing procedures (if within 1 week of the initial consultation), then the $95 consult fee will be credited towards any initial testing or examination fees.

Become a Patient Form

Name*
First Last
Email*
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Date of Birth*
Date Format: MM slash DD slash YYYY
How did you hear about us? Please be specific.*
What are the main health concerns that are bringing you to BioHealth? Please be specific.*
What are the best days and times for a consultation? (Please refer to times within our business hours)*
Signature*