Patient Questionnaire

To understand your health journey, we ask new patients to fill out our questionnaire before we start the process. This ensures we can provide the care you're looking for. Once you've submitted your information, a team member will contact you and guide you through the next steps.

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Patient Questionnaire

Name(Required)
Please enter a number from 1 to 10.
1= Not Important, 10= Extremely Important
Please enter a number from 1 to 10.
1= Not willing, 10= I'll do whatever it takes!
How soon are you willing to start taking the steps to reach your health goals?(Required)
How much are you currently willing to invest in your health?(Required)
How did you hear about us?(Required)

If you have a referral, please let us know who they are in the "other" box so we can thank them!
I understand that Julie Taylor MD and her care is not contracted with any health insurance companies in order to have complete freedom to serve people at the highest level possible.(Required)