Request Appointment Form (208) 646-4165 (208) 646-4195 415 N. 3rd Ave Ste B Pocatello, ID 83201 Please enable JavaScript in your browser to complete this form.Please enter your first and last name *FirstLastPlease leave your phone number below: *We'll send you an email to confirm your appointment. Please provide us with your email address. *NextPlease select the service type below: *Psychiatric Mental HealthGeneral Family WellnessHormone Replacement TherapyNutrition & Weight ManagementMigraine TherapyTMD TherapyAesthetics ConsultationCosmetic BotoxEyebrow MicrobladingFillersNextWhat day works best for you? *Disclaimer: this is NOT the official date, we will contact you shortly.Please select a time. *Disclaimer: this is NOT the official time, we will contact you shortly.Your privacy is important to us! We are committed to protecting the confidentiality of your personal health information and comply with all applicable federal and state laws, including the Health Insurance Portability and Accountability Act (HIPAA). Rest assured that any information you provide will be kept confidential and used only for the purpose of providing you with quality care. *I have read and understood the HIPAA statement.Request Appointment
