Schedule Your Initial Cardiovascular Consultation - Advanced Functional Cardiovascular Care

Cardiovascular Consultation Intake Form
Full Name*
Email Address*
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Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
To help us prepare for our conversation, please select the area(s) that best describes your current focus:*

Review of my DexaFit Data and Clinical ManagementHeart attack Prevention and Advanced Cholesterol ManagementBlood Pressure ControlIrregular heart rhythm(AFib)Longevity and Optimizing Heart PerformanceReversing prediabetes, insulin resistance and cardiometabolic riskProactive Care For Those With a Family History of Heart diseaseGeneral Cardiovascular Consultation
We are delighted to welcome our DexaFit clients. Have you already completed your DEXA scan?*

Yes, I have my DexaFit results ready for reviewNo, I plan to schedule my DEXA scan soon
Please describe the specific heart and vascular health concerns you wish to discuss during the consultation.*
What are the top 3 outcomes you want to achieve regarding your heart and vascular health over the next 12 months?*
Durable cardiovascular healing and root-cause transformation require a dedicated, collaborative approach between the patient and the Physician. To provide the depth of investigation and personalized care necessary, AFCC operates exclusively through an annual concierge membership.
Are you seeking a proactive, long-term physician-patient partnership for your health journey?*

Yes. I am seeking a dedicated, long-term partnership and understand the 12-month commitment.No. I am currently looking for a one-time visit or per-appointment care at this time.
How did you hear about this practice?*

DexaFit AtlantaDexaFit ColumbusReferral from another PhysicianReferral from a friend or family memberGoogle searchLinkedInWebsite article or blogOther
What is your preferred time of day for us to contact you for your discovery call?*

MorningAfternoon
Thank you for providing this clinical context to help us prepare for your consultation.

To finalize your request, please click the button below. You will be automatically redirected to our calendar to secure a time for your session.

We look forward to meeting you and discussing a comprehensive strategy for your heart and vascular health.
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Cardiovascular Consultation Intake Form