New Patient Forms

Download the necessary form(s)

Medical Aesthetics

New Patient Medical Aesthetics Packet

Medical Marijuana

Patient Intake Form
Medical Marijuana Consent Form

Medical Patient

New Patient Form

Patient Access Program Applications

Radiesse Patient Access Program
Sculptra Patient Access Program

Financing

Enhance your appearance without financial stress. Use CareCredit to create a payment plan that fits your budget.

Cape Coral

239.540.9918

4202 Del Prado Blvd. S.
Cape Coral FL, 33904

Tuesday – Thursday: 9am – 7pm

Request an Appointment

To schedule a complimentary consultation or to learn more about your options, call Advanced Integrative Medicine at 239.540.9918 or send a message using the form below. Take your first step to becoming a happier, more youthful you!

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