ED Intake
Take the First Step Toward Regaining Confidence
Welcome to the ED Intake Form. At Peak Family Health, we prioritize your health and privacy. This form marks the first step in our simple and secure process to help address your concerns. By completing the intake, you’ll provide us with the essential details we need to understand your needs and begin creating a personalized treatment plan tailored to you. Rest assured, your information is handled with the utmost confidentiality, and our team is here to support you every step of the way.
Read the instructions below and complete the form at the bottom of the page. Our provider will review your form and quickly reach back out to you.
Step 1: ED Consultation Intake
The process begins with a brief ED Consultation Intake Form, where you’ll provide basic information about yourself and your reason for seeking care. This is a quick and asynchronous (not in-person) process, allowing you to complete it at your convenience.
- Cost: $65, payable at the time of submission.
- What happens next: Our provider reviews your submission to ensure a successful payment. Upon approval, you’ll receive a Patient Medical Intake Form via email (if you’re a new or returning patient without updated information).
Step 2: Medical Intake and Review
Once you’ve completed and submitted the Patient Medical Intake Form, our provider will:
- Review your information to better understand your medical history and health needs.
- We recommend and prescribe the appropriate ED medication, then communicate the plan through your secure Patient Medical Portal. Instructions for accessing the portal are included in the email.
Prescription Fulfillment
We send medications to your chosen pharmacy, as specified on your Medical Intake Form. You can easily manage follow-ups and refills through the secure Patient Medical Portal, ensuring convenient and confidential ongoing care.