Returning Patient Consultation Form

If you are a Returning Patient (you've had a custom formula at any point in the past), please read about appointment types below, then scroll down to see the scheduler and choose your appointment type to get started.


Returning Patient FULL Consultation (45 minutes)
Use this appointment type if…

☑I let you know during a previous consultation that we would need to monitor your health changes and make significant adjustments to your formula over a period of time to achieve your goals.

☑Your health or symptoms change in an unexpected or dramatic way while using your formula as directed and you feel you need your formula or treatment plan to be adjusted.

☑You receive new information from another health care provider that you believe will change your treatment plan, such as a new diagnosis or lab results.

☑You are concerned about the effects of your formula, or have multiple questions and want to discuss your treatment plan with me in depth and it will take more than 25 minutes.

☑It has been more than 3 months since your last consultation, your health or symptoms have changed substantially, and/or you believe you need a new formula.

Returning Patient BRIEF Consultation (25 minutes)
Use this appointment type if...

☑I let you know during a previous consultation that I would need you to report back to me on specific symptom changes in between refills.

☑You have an acute (rapidly developing) but non-emergency illness such as:

❧Cold/Flu
❧Gastroenteritis/Stomach Bug (diarrhea, nausea, and/or vomiting)
❧Urinary Tract Infection
❧Rash
❧Fever
❧Earache
❧Sore throat
❧Muscle spasm
❧Injury

*We recommend using a laptop or desktop computer to schedule and complete your forms. If you have any technical trouble, email help@estuaryherbs.com and we'll be happy to assist!*