Questionnaire
Registration
H.E.A.L. Plan Registration
Our Health Enrichment and Lifestyle (H.E.A.L.) Plan is designed to optimize your overall health and wellness through recommendations for preventive health, and optimizing the management of existing conditions.
Our recommendations are rendered based upon answers you provide through an intake questionnaire outlining potential factors for risk.
As physician owners and operators, we will provide an independent, unbiased, professional assessment based on the highest standard of healthcare.
Through our private questionnaire intake process, we are able to give you the security in knowing the information is used solely to give you the most appropriate recommendations based on your risk factors. Our goal is to bridge the gap that exists between physicians and patients through empowering you to become a more active participant in your own healthcare.
How To Begin Your Questionnaire:
Please click the Pay Now button below to register for your H.E.A.L. Plan Questionnaire.
This Questionnaire will take 7-10 minutes on average to complete. If you are unable to complete the Questionnaire at this time, you will be emailed a link that will give you access to complete this form at your convenience.
If you do not receive the email, please check your Spam folder and then contact us at:
877.449.4094 or email us at support@urbanhousecallmagazine.com
Please have your Paypal transaction ID ready and we will provide you with a link to begin taking the Questionnaire.
Please click the links below if you would like to view sample H.E.A.L. Plans
H.E.A.L. Plan Male
H.E.A.L. Plan Female
Thank you so much for completing the H.E.A.L. Plan questionnaire!
You are one step closer to learning more about how to improve your overall health and wellness.
Our physicians will now begin reviewing your data and creating your personalized health assessment.
You should receive your H.E.A.L. Plan within 72 business hours via email.
If you would like to change the delivery method of your H.E.A.L. Plan for any reason, or if you do not receive your H.E.A.L. Plan email, please contact us at 877.449.4094 or email us at support@urbanhousecallmagazine.com.




