Virtual Group Visit Interest Form
Thank you for your interest in our virtual group visits! 

We are currently offering 3 different groups: 
  • Peri/Menopause which meets every 2nd Tuesday of the month at 11:30am CST / 12:30pm EST for residents of TN or FL
  • Peri/Menopause which meets every 4th Tuesday of the month at 12pm CST for residents of TX
  • Weight Management which meets every 2nd Thursday of the month at 12pm CST for residents of TN
If these group dates/times/types do not work for you but you're still interested in group visits, we encourage you to still fill this out, as we will be looking to expand our group offerings in the near future and would love your feedback. 
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Legal Full Name (first and last, as recorded on your patient chart) *
Email address (if you do not have the DH app or are not currently a patient, this is our only means to follow up)
What state are you located in? *
How did you hear about our Virtual Group Visits? *
Which of our group visits are you interested in? *
Are you able to make the current day and time work for the group you're interested in?
If no, what days and times would you be available?
Are you ready to sign up?
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What other group types would be of interest to you in the future?
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