Choose the visit that matches what you need.
The booking experience is intentionally split so concierge patients and insurance-based pain patients are not forced through the same form.
A comprehensive first visit with Dr. Nessim.
A 60-minute conversation that can address hormones, metabolic health, pain, recovery, longevity, aesthetics, or several goals together. Confirm the current fee and any credit policy before publishing.
Request an in-person evaluation.
For sports injuries, joint or spine pain, musculoskeletal conditions, and post-surgical care. The practice should verify benefits before promising coverage. Avoid collecting insurance card images or full clinical details on this public form unless HIPAA configuration is complete.
Protect privacy by collecting less.
A conversion form is not the medical chart. Collect contact information and routing details first, then move clinical intake into a properly configured secure process.
What should the first form ask?
Name, email, phone, state, care path, preferred appointment format, and consent to be contacted are usually enough for initial routing.
What should stay off the public lead form?
Detailed symptoms, diagnoses, medication lists, imaging, insurance card images, member IDs, and other sensitive health information unless the account and workflow are configured for HIPAA-compliant handling.
Can GHL connect form submissions to workflows?
Yes. Use separate forms, tags, pipelines, and workflows for the concierge and pain tracks so each patient receives the correct follow-up sequence.