Become a patient / Hacerse paciente
We’d love to learn a little about you before you join so we can guide you to the right next step.
Preferred language
*
English
Spanish
Back
Next
Dr. Andrews is currently accepting a limited number of new patients.
Please complete this intake questionnaire to get started. Once submitted, you’ll be prompted to schedule a complimentary Meet & Greet.
What brings you in today?
*
Primary Care Membership — For ongoing primary care, direct access to your doctor, and comprehensive preventive and acute care.
Metabolic Health Consultation — For insulin resistance, PCOS/PMOS, weight resistance, inflammation, prediabetes, cholesterol concerns, and metabolic health.
Hormone Health Consultation — For perimenopause, menopause, cycle concerns, fatigue, libido, hormone symptoms, and hormone optimization.
Gut Health Consultation — For bloating, digestive symptoms, gut concerns, food sensitivities, microbiome concerns, and chronic digestive issues.
I'm not sure — please help me determine the best fit — Many patients overlap between programs. Select this and we'll help guide you.
I consent to Direct Primary Care of West Michigan contacting me about membership and understand this form is not a clinical visit.
*
[object Object]
Please enter your full name.
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
How did you find out about Direct Primary Care of West Michigan?
*
[object Object],[object Object],[object Object],[object Object]
Other
Do you currently have a primary care clinician?
*
No
Yes, I want to change
Yes, keeping both/dual care
Are you familiar with the basic concept of Direct Primary Care?
*
Yes
No
Unsure
If you are familiar with direct care, what led you to consider this instead of traditional insurance-based primary care? (Optional)
Why are you interested in our practice specifically?
*
How would you describe your current experience with healthcare? What works well, and what could be improved? (Optional)
What are your primary health concerns or goals right now?
*
Back
Submit
Edad
Submit
Should be Empty: