Golden Leaf HealthMenopause Care

Choose a time for your first visit

Initial Medical Visit · 30 minutes · video visit from home · $99

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Available times · Pacific

Free cancellation up to 24 hours before your visit

Tell us who you are

Just the essentials. Your full health story comes later, at your own pace.

First namePlease enter your first name
Last namePlease enter your last name
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Date of birthPlease enter your date of birth
State you live inPlease select your state

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Review and pay

Initial Medical Visit · video
Due today$99.00
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You're booked

One more step before your visit
Your health questionnaire. About 10 minutes.
Save anytime and finish later from the link in your email.

Welcome

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Your answers save automatically after each section. You can close this page and come back anytime.

About you

Your mailing address helps us verify coverage and send anything your care requires.

Street address Apt / unit (optional) City
State
ZIP

Your health history

There are no wrong answers here. This helps your doctor understand the full picture.

Which best describes your menstrual cycle in the past year? Are you currently on hormone replacement therapy?
Are you currently on birth control?
Have you had a hysterectomy?
Have you had your ovaries removed (oophorectomy)?
Weight (lbs)
Height (ft)
(in)
Medications you take (add each one)
Allergies (add each one)
Your medical history. Check what applies to you.
Any family history of the following?

Your symptoms

Rate how much each affects you these days.

0 = not at all5 = severe

Consent & signature

The last step. Please review and sign.

Type your full legal name as your signature
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