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Functional Medicine Forms & Fees 

Welcome! We are excited for you to start care.  In order to get started with care, please complete the intake form below. Once we receive your completed form, we will contact you to set up your appointments. *This comprehensive intake form may take 60min+ to complete. 

Please review the fees below as we are an out-of-network insurance provider.  (You can check your insurance for out-of-network benefits)


Not ready to start as a new patient yet? Still have questions? Thats okay, we offer a no charge 10min Meet & Greet with Dr. Emily. For financial or administrative questions please call Deanna at 636-812-3800. To interview Dr. Emily, please complete the Meet & Greet form below and Deanna will call you to schedule your 10min appointment. We offer video telemedicine appointments as an option and you can log in to our virtual waiting room at the link below. 


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