alcure signup

We use Google Workspace forms designated for medical practices. All your information is encrypted to HIPAA standards as you enter it and stored safely in our secure Google Cloud environment.
Email *
Our signup is fast and easy. Start with our medical questionnaire below, it's brief and user-friendly. We'll send you a verification email afterward to the email address used above. Follow the remaining steps in the verification email to set up your initial physician's video chat consult. Reach us at with any questions.
First, are you 21 or over (we can only treat clients 21 and over)? *
Now, is your preference to stop drinking completely or to continue but just cut back? *
You're not seeing the results you expected from other self-restraint treatment methods such as AA or moderation management? *
Do you feel drinking is causing weight gain and you would like to lose some weight? *
Do you see yourself as facing some limitations in your social life because you feel a need to avoid other people who drink alcohol, or avoid places where alcohol is present, and you would like to eliminate these restrictions? *
Do you want to improve one or more relationships by cutting back or stopping drinking? This could be a social relationship or something more formal, such as an employment relationship. *
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