Schedule a follow-up appointment Name* First Last Email* I am requesting a follow-up appointment for:* Functional Medicine Thyroid Care Nutritional Consultation Counseling, Hypnotherapy Other Type of appointment requested* Office consultation Phone consultation Phone consultations are available for patients who live more than an hour's drive from our office. By law, all patients must have been seen in person in the last 12 months in order for Dr. Katz to prescribe medications for you.Month in which you would like to be seenJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDays of the week that may work for you Monday Tuesday Wednesday Thursday Friday Saturday Times of day that may work for you Early Morning (8am to 10am) Late Morning (10am to noon) Early Afternoon (noon to 2pm) Mid Afternoon (2pm to 4pm) Late Afternoon (4pm to 6pm) Evening (phone appointment only) Please indicate any dates and times during the requested period in which you are NOT AVAILABLEPlease share any additional information about your request in this box. If the appointment you are requesting is for a condition for which you have not yet seen Dr. Katz, please use this space to explain.
