Free 15 Min Phone ConsultatioN

Thank you for your interest in my practice. 

I want you to feel confident in your decision to work with me, therefore, before signing up as a new patient, I offer free 15min consultations to eligible prospective patients. This consultation will give you an opportunity to discuss your case with me and for us both to determine if you are a good fit for my practice.

Before requesting a free consulation, I encourage you to fully explore the information on this site, in particular the pages linked below. These pages answer most questions my practice receives from prospective patients. Functional medicine differs from conventional medicine in many respects. It is therefore important to understand the unique goals and methods behind my approach to care. 

About Dr. Stagliano
What is Functional Medicine
Your First Visit and Treatment Programs
Fees & Insurance Policy

Conditions Treated
FAQ

If after exploring the information above you are still interested in potentially becoming a patient, please complete the free consultation request form below. I review each submission to make sure that you are a good candidate for a Functional Medicine approach and will then have someone on my team reach out to you to schedule the free consultation. If I do not think that my practice is a good potential fit for you, my team will also let you know and we will do our best to refer you to any other practitioners or resources we are aware of. 

Please note:   If you would like to get in touch with my practice for reasons other than becoming a patient, or if you have questions you would like answered before scheduling a free consultation please use the contact form found here.

1. CONTACT INFORMATION
Your contact information will stay strictly confidential.
Please note: Dr. Stagliano does not treat patients under 18 years old. In addition, if you are not the prospective patient, Dr. Stagliano will NOT be able to discuss your spouse/partner/family members case with you unless they are also an interested participant on the call.
Name *
Name
Preferred Phone # *
Preferred Phone #
Is it okay to leave a message at the number above? *
2. Questions
Your answers will stay strictly confidential.
My medical license requires that I meet with a patient in person in order to provide an initial medical consultation. In addition, I find that there is no substitute for that initial doctor-patient connection.
3. INFORMED CONSENT
I understand the 15-minute complimentary consultation is used to determine if I am a candidate for care and does not establish me as a patient of Rich Stagliano, MD. I also understand there is no doctor-patient relationship or obligation between myself and Rich Stagliano, MD based on meeting for a complimentary consultation.
Do you understand and consent? *