***Interested in Scheduling a First Appointment?
Please answer the following questions so we can learn more about you and about your interest in seeking care from Dr. Bluestein. A member of the Hypermobility MD team will follow up with you about whether we may be able to help. Please read office policies, pricing, and package options before continuing. Return to this form after you have chosen your package. https://tinyurl.com/3zzxpx4v One-on-one medical care is expensive! If you need a more cost affordable option, are not a US citizen, and/or cannot travel to CO or WI for your first appointment, then coaching is a better choice for you. Visit https://www.hypermobilitymd.com/educoaching and hit the "Tell me more" button.
First name
Last name
Email
Phone Number
Address
How did you hear about us?
Friend or family member
Instagram
Facebook
Twitter
LinkedIn
Fellow patient of Dr Bluestein
Bendy Bodies Podcast
Other
I was referred to Dr Bluestein by:
What are the top three medical issues you would like to address?
1000
What do you hope to achieve in working with Dr. Bluestein?
1000
What have you tried in the past?
1000
Do you understand that Dr. Bluestein does not accept insurance and that you will be responsible for payment before services are rendered?
Yes
No
Are you aware that most chronic medical conditions require time for improvement, and you likely will have to work with Dr. Bluestein over a reasonable period of time to improve your quality of life?
Yes
No
Is there anything else you would like to add?
1000
Which in person location are you willing and able to travel to (for your first appointment)?
Littleton, Colorado - 8091 Shaffer Parkway
Arvada, Colorado - 8795 Ralston Road
Green Bay, Wisconsin - 2304 Lineville Road
If none of the above, please visit https://www.hypermobilitymd.com/educoaching
Which package do you feel is the best fit for you?
Diamond (appropriate for most people who suspect EDS, HSD, POTS, or MCAS)
Platinum (appropriate for people who are NOT complex)
Gold (only for a single straightforward problem)
Submit
Powered by