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 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!
Payment Structure Options(Required)
Julie Taylor MD and her team are a concierge practice, and are not contracted with any health insurance companies. This allows her and her team to serve patients at the highest level possible. Fees range from $6,500-$8,000 per year. If you choose to move forward with care, we offer flexible payment options to accommodate different budgets. Please indicate which structure you would prefer, should you decide to enroll: