Please fill out this contact form and we’ll get back to you shortly.

1

Select your state* This field is required.

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2

Full Name* This field is required.

First Name

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3

Date of Birth* This field is required.

Date

4

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6

How did you heard about our services?

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7

Telemedicine Informed Consent, HIPAA NOTICE OF PRIVACY PRACTICES And Refund Notice* This field is required.

8

Signature* This field is required.I have read and agree with Text2MD Telemedicine Informed Consent, HIPAA NOTICE OF PRIVACY PRACTICES And Refund Notice

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9

Which service do you need?* This field is required.

Weight Loss & GLP-1

Long COVID Recovery

Hormone Therapy (HRT)

Gut Health & Metabolic Reset

General Medical / Urgent Care (For minor illnesses, prescriptions, or general health questions)

10

How would you prefer to have your consultation?* This field is required.

Secure chat (text messaging) – $35

Video call – $65

I’m not sure – happy to follow the doctor’s recommendation

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Video Consultation AppointmentSelect a convenient time for your virtual consultation. A Zoom link will be sent to your email after booking.

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Thank you for submitting your intake form — we’ve received it ✅

📋 What’s next?

Our clinical team will review your information and follow up within 1 hour or less.
(Waiting time may be up to 4 hours on weekends, holidays, and outside business hours.)

📲 You’ll soon receive a text message with an invite link to Spruce (our secure messenger app).

👉 Click the link to connect with us on Spruce — this is how the doctor communicates with patients and conducts telemedicine visits.

💬 Once connected, you can message the doctor directly via secure chat.

We’re excited to support you on your health journey! 💙

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Booking Provided by Healthie

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HRT Booking Provided by Healthie

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Initial Consultation with Dr. Antonatos - Booking Provided by Healthie