Functional Medicine Appointments

Functional Medicine Consultation

Please select a time to schedule your appointment with Dr. Bailey Bolinske, PharmD, CFMP. Appointment deposits are non-refundable.
Appointment *
Appointment Type *

Nutritional consultation Hormone Replacement Therapy consultation

Patient Demographics
Name *

First Name Last Name
Address *

Street Address

County

City State

Zip Code
Date of Birth *

Month Day Year
Email *
example@example.com
Phone Number *
Sex *
A separate patient intake form must be completed at least 72 hours prior to your appointment. After booking your appointment, you will be automatically redirected to the patient intake form. If you need to complete it at a later time, a URL link will be provided to you in your appointment confirmation email. By initialing below, you agree to complete the intake form at least 72 hours prior to your appointment: *

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Payment *

Functional Medicine Consultation Deposit $ 120.00

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Total $ 0.00

Functional Medicine Consultation