Precision Health and Men

CONFIDENTIAL ACKNOWLEDGMENT:

Please review and confirm each statement below before scheduling your consultation. All information is strictly confidential under HIPAA.
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Address

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Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
I understand there is no charge for the Discovery call
I understand the $150 fee covers my in-person consultation and good faith exam, is non-refundable, and will be credited toward my treatment cost if I proceed.
I understand that rescheduling requires at least 48 hours' notice, and that rescheduling with less notice or not showing up will forfeit this fee.
I understand this consultation is confidential and protected under patient privacy laws.
I understand this is a confidential consultation protected under patient privacy laws.
I understand that if a penile nerve block is performed, it will be administered only by a licensed Nurse Practitioner, not RN staff.
I confirm I have read the Privacy & Policies page.
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Select below to acknowledge the terms and gain access to our exclusive scheduling portal, where you may book your complimentary discovery call.
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CONFIDENTIAL ACKNOWLEDGMENT: