Complete and submit the Medical History form available on our website when health or personal information changes occur.

Alternately one can be obtained at our office or by mail upon request.


Office Consultations:


* Initial Comprehensive Laboratory and Clinical Assessment Consultation – $250

Review of medical history

Previous testing


Patient symptoms and concerns

Identify clinical issues

Design labs specific to symptoms/concerns (comprehensive test panel paid for by our office)

Design individualized initial therapy (1 month)

In office (via phone if extenuating circumstances)

Review of lab results

Design of individualized therapy

Delivery of written lab review by Dr Carlson, with detailed explanations


Quarterly Comprehensive Clinical Assessment Consultation – $175

In office (via phone if extenuating circumstances)


Review of patient’s treatments and clinical response

Identify adjustments and additional therapies



Prescriptions will be written for either 1-month with 2 refills or 3-months (depending on medication/insurance).



Dr Carlson does not bill insurance. In the case of most pharmacies, we can submit prescriptions electronically; allowing us to tell you immediately which medications will be covered by your insurance plan and which will not be covered. Insurance information must be provided prior to prescriptions being written for this to occur. This also streamlines the process for pharmacies that bill insurance.


* Only applicable at the beginning of the treatment program.


Discontinuing Treatment

You may discontinue your treatment at any time. If you have already scheduled your next appointment, we ask that you cancel the appointment at least 24 hours in advance.



______________________________ ____ / ____ / 20____

Patient Signature (if you understand the prices and frequency of appointments required for treatment)