Become A Patient Application

Once we get this completed form back from you, Dr. Gina will review your information and if she feels it is a good fit, clinically, then we will schedule you for a FREE 20 minute phone consult where you and Dr. Gina will become better acquainted and discuss what it is you are seeking support for. Dr. Gina will then explain the proposed plan of action and what the next steps will be to get your treatment process going.

After submitting, you will soon receive a confirmation email and we will email you to schedule your Free 20 min tele-consult with Dr. Gina.  If Dr. Gina feels you both are not an optimal clinical fit, we will then provide you with referrals for other clinicians better clinically matched for your specific health care needs. 

NOTE***Sometimes our reply emails to New Patient inquiries land in people’s junk/spam email boxes. Please check your spam and or junk email boxes for our reply email coming from an email address containing “”, if you don’t see a reply email from us in your main email box within 48-72 hours of submitting your New Patient inquiry.