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Share your contact details and preferred time—our team will reach out to discuss your enquiry.
First name
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Last name
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Phone
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Format: (000) 000-0000.
Email
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example@example.com
Are you currently enrolled in Medicare, Medicare Advantage (a Medicare plan run by a private insurer), or Medicaid?
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No
Yes
I am not sure
Before you go further, please read this. Navara Health is a private-pay practice and is not able to accept patients enrolled in Medicare, Medicare Advantage, or Medicaid. This is a limitation on how our practice is structured, not a reflection on you or your care needs. Your provider is required to maintain Medicare enrollment through other clinical work and cannot opt out of the program. Federal rules do not permit an enrolled provider who has not opted out to see Medicare patients on a private-pay basis, even if you would prefer to pay out of pocket. You are still welcome to submit this form and we are happy to talk with you, but we want you to know before you spend any time or money with us.
What brings you in?
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Perimenopause or women's hormones
Men's hormones or testosterone
Weight management
Thyroid
Laboratory testing
Aesthetics or skin
IV therapy or injections
Regenerative protocols
Primary care membership
Not sure yet
Best time to reach you
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Please let us know how we can help...
Please keep medical details out of this form. Anything clinical is discussed on the call or through the patient portal.
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