Discovery Call Request - Advanced Functional Cardiovascular Care

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Thank you for your interest in Advanced Functional Cardiovascular Care. This brief request form helps the practice to understand your goals and determine whether a 15-minute discovery call is the appropriate next step.

Please do not include urgent concerns or sensitive medical details.

If you believe you may be experiencing a medical emergency, please call 911 or go to the nearest emergency department.
Full Name*
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
What is your primary reason for requesting a discovery call?*

Preventive cardiovascular risk assessmentAtrial fibrillation or rhythm concernsBlood pressure or cardiometabolic healthI am not sure and would like guidance
Are you seeking physician-led medical care through a concierge practice?*

Yes, I am seeking physician-led medical careNo, I am looking for general information only
How did you hear about this practice?

Google searchReferral from another PhysicianReferral from a friend or family memberLinkedInWebsite article or blogOther
Thank you for your interest.

This practice provides physician-led concierge medical care.

If you are seeking general educational information only, please visit the resources available on this website.

If you would like the practice to review your request and determine whether a brief discovery call may be appropriate, please continue below.
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