New Patient Enrollment Form

Welcome to Complete Medicine! If you're sick and tired of feeling sick or tired, your journey to personalized care that listens, supports, & takes you seriously starts here.

Please take a moment to review and provide the info below so we can connect and help you schedule your first 60 minute appointment. We look forward to meeting you!

Preferred Provider(Required)

Name(Required)

Email(Required)

Home Phone

Mobile Phone(Required)

Gender(Required)

What sex were you assigned at birth on your original birth certificate?(Required)

What is your current gender identity?(Required)

Date of Birth(Required)

Address (currently available in Texas & Oklahoma)(Required)

Name of Company or Group (if applicable)

Share Your Info - We’ll Help You Book Your First Visit

Just a few quick details and one of our trusted team members will reach out to answer any questions and walk you through next steps.

You’ll get support scheduling your first 60-minute appointment with a board-certified endocrinologist. (Currently serving Texas & Oklahoma patients)

Name(Required)

Phone(Required)

Email(Required)