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Women’s Health
Men’s HealthNew Patients
New Patients
If you are a new patient, please download, print, fill out, and bring the appropriate Patient Information/Intake forms to your appointment, and continue reading this page:
Women’s Intake Forms
- Women’s Intake Form, click here
- Women’s Consent Form for Bioidentical Hormone Replacement Therapy, click here
- Notice of Privacy Practices, click here
- HIPPA Privacy, click here
- Medical Appointment Cancellation Policy, click here
Men’s Intake Forms
- Men’s Intake form, click here
- Men’s Consent Form for Bioidentical Hormone Replacement Therapy, click here
- Notice of Privacy Practices, click here
- HIPPA Privacy, click here
- Medical Appointment Cancellation Policy, click here
Cognitive Health Form
Getting started with your Bioidentical Hormone Replacement Therapy Consultation
Thank you for inquiring into BHRT at Synergy. Following is the process we ask you to follow so we can gather important information about you.
Please note, we do not participate in insurance. We do however send your blood work to a lab that your insurance takes.
The initial intake consult is $575 and includes the first follow-up.
The first step is to provide us with the following information when you call:
- Are you on any synthetic hormones (birth control included)?
- Do you have a menstral cycle? (if you do, you go for blood draw on day 3 or 4 of cycle)
- Do you have any recent labwork from another doctor (not older than a year)? After talking with us, you can fax the labs to 410-5862, so that we may prepare your lab order for Synergy. It’s good to know what lab takes your insurance, so you may want to call your insurance co and find out.
The initial visit, whether in-person or through a telemedicine appointment, is about one hour and includes a comprehensive evaluation with Dr. Long or Dr. Ryder, and your lab results. From that, an individualized treatment plan will be formulated according to your needs and explained in-depth.
After this visit you will also receive a written treatment plan with all recommendations reiterated. After implementation of your hormone replacement therapy, a 30-minute consultation will be done to review updated lab work and determine progress.
Established Patient Follow-Ups
Restoring hormone levels to optimal levels requires work on the part of the physician and the individual in treatment. Follow-up appointments are made based on levels achieved during previous blood draws and the patients need. All follow-ups are $250.
Phone Consultations
Dr. Long and Dr. Ryder understand that it is frequently not convenient to have a face-to-face consultation about hormonal manners. We are pleased to offer scheduled phone follow-ups which usually last a half-hour for $250.
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