Returning Patient Telehealth Appointment REQUEST (updated 1/21/2021)

January 21, 2021: All of our offices are open.  Please make an in-person appointment for your visit for a better experience and more success in your weight loss journey. ****

*All OPEN locations will limit the number of persons allowed inside for the time being.


Please wear a mask when entering our medical offices.

For in-person appts at our clinics:
Returning Patient Telehealth Appointment Request (updated 10/16/2020)
for orders and medical services
If paying with CareCredit, please provide CareCredit Card Number, Name of Card Holder, and expiration date of your Driver License
Please contact us if you have questions. We only charge fees for the services provided and ONLY if you agree to the charges.
Enter your notes/comments here
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I AM REQUESTING that you call me on my cell phone number DURING which time and date (write below) _______________. I AGREE THAT THERE IS A POTENTIAL DELAY OF 72 BUSINESS HOURS TO FOR A CALL-BACK. However, we typically send out plans and your instructions in the mail the same business day we speak to you on the phone. I agree to wait 3 business days for a phone call from Elevation Medical, then I will be provided with a tracking number of the mailed-out dietary guidance.

updated 1/21/2021