Appointment Request

To schedule an appointment or to obtain additional information about services, please fill out the form below or call 614.940.4868. Please understand our availability can quickly change for many reasons. We will do our best to accommodate you but may be unable.

We strive to reach you within 1 to 3 business days, if not sooner. Please reach back out if you have not heard from us within 3 business days.

Name *

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Last

Email *

Phone Number *

Preferred Day *Select…SundayMondayTuesdayWednesdayThursdayFridaySaturday

Please select your preferred time *

• Early Morning
• Late Morning
• Early Afternoon
• Late Afternoon
• Evenings
• Weekends

You may select more than one.

Preferred Method of Contact *Select…EmailPhone

If you choose email, be sure to check your spam folder.

Breast Health & Wellness

• Integrated Care Team – Jodi Gibbs, BSW, PA-C, MPAS and Amy Durtschi, M.S., LPC

Dietitian

• Laurie Coleman, RD, LD

Medication Management [except for stimulants, benzodiazepines, and suboxone]

• Justin Kerr, APRN, PMHNP-BC

Psychological Testing – Self Pay Only

• Dr. Michael D. Wagner, Ph.D

Urban Zen Integrative Therapy [Yoga | Meditation] – Self Pay Only

• Alissa Jackson, LISW-S, RYT 500

Preferred Location *

• In Office
• Video Call
• Either

Message *

Is it ok to leave you a voicemail if you don't answer? *

• Yes
• No

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