Moderate Complexity New Patient Application
Congratulations on taking the first step toward better understanding your health.
The way Dr. Hagmeyer works with patients is different from the conventional medical model many people are accustomed to.
Our office uses a holistic, Functional Medicine approach that looks beyond symptoms alone and considers how multiple systems in the body may be contributing to your health concerns.
Dr. Hagmeyer does not prescribe medications, and he does not replace your Primary Care Physician or other medical specialists.
Instead, he focuses on understanding the bigger picture through a careful review of your health history, symptoms, previous testing, medications, supplements, nutrition, lifestyle, and appropriate laboratory findings.
Dr. Hagmeyer believes in testing, not guessing.
The information you provide in your New Patient Application is an important part of this process, so please take your time and complete it as thoroughly as possible.
Complete Your Moderate Complexity New Patient Application
You have two options for completing your paperwork.
Option 1: Complete the Application Online
You may complete the Moderate Complexity New Patient Application electronically through our secure online form.
Complete Your Moderate Complexity Application
Option 2: Download and Complete the Application
If you prefer, you may download the New Patient Application, complete it on your computer, and scan it back to the office
Please follow all instructions included with the application.- Special note: Do not mail it to the address listed in the application.
If you are scanning your paperwork, please send clear, single-sided scans.
Pictures of completed paperwork are not accepted.
Completed paperwork may be emailed to:
Why Your New Patient Application Is Important
Your symptoms are only one part of your health story.
Your application helps Dr. Hagmeyer understand:
- When your health concerns began
- How your symptoms have changed over time
- Previous diagnoses
- Previous treatments
- Medications
- Supplements
- Dietary patterns
- Digestive symptoms
- Hormonal symptoms
- Thyroid symptoms
- Sleep and stress patterns
- Previous laboratory testing
- Lifestyle and environmental factors
The more complete the information you provide, the better Dr. Hagmeyer can understand the context of your case.
Please Complete Your Health Narrative and Food Journal
The Moderate Complexity application includes a detailed health narrative and a 7-Day Food Journal.
Please begin your food journal as soon as possible and record your food and beverage intake as accurately as you can.
Your health narrative should also be completed thoroughly.
Please type your narrative rather than handwriting it so that Dr. Hagmeyer can review it efficiently before your appointment.
What Happens After Your Application Is Submitted?
Once your completed New Patient Application has been received, your file will be reviewed to make sure the information necessary to move forward has been provided.
The general process is:
- Complete your New Patient Application
- Complete the testing recommended or required by Dr. Hagmeyer
- Complete your Case Review
- Begin your personalized treatment plan
- Retest when appropriate to assess progress and make adjustments
This structured process allows Dr. Hagmeyer to begin your evaluation with both a detailed health history and objective laboratory information.
Testing Comes Before Your Case Review
Testing is an important part of Dr. Hagmeyer’s initial evaluation.
Rather than making treatment recommendations based on symptoms alone, Dr. Hagmeyer uses laboratory information to establish a current baseline and better understand the patterns that may be contributing to your health concerns.
Depending on your individual case, testing may evaluate areas such as:
- Thyroid function
- Blood sugar and insulin regulation
- Inflammation
- Hormone balance
- Iron status
- Nutritional status
- Cardiovascular health
- Liver and kidney function
- Blood cell and immune patterns
- Digestive health
The goal is to have the information Dr. Hagmeyer needs before your Case Review so that your appointment can focus on understanding your results and discussing the next steps.
Do You Already Have Recent Testing?
If you already have recent testing from another provider, please include it with your application.
Dr. Hagmeyer will review one previous test from another provider, provided it was completed within the last three months.
If that testing is current and contains information Dr. Hagmeyer needs for your evaluation, it may not be necessary to repeat that particular test.
Testing older than three months may still provide useful historical information, but Dr. Hagmeyer does not use older results as the basis for current treatment recommendations, since laboratory values and health patterns can change over time.
What Your Moderate Complexity Case Review Includes
Before your Case Review, Dr. Hagmeyer reviews the information you have submitted along with the testing required for your initial evaluation.
Your Case Review may include:
- Review of your completed New Patient Application
- Review of your detailed health history and typed narrative
- Review of your 7-Day Food Journal
- Review of your medication and supplement history
- Review of one previous test from another provider/ Functional Medicine Practitioner
- Review of your current baseline laboratory testing
- Review of important patterns identified within your case
- Consultation with Dr. Hagmeyer to discuss your results and recommended next steps
The purpose of the Case Review is to bring the different pieces of your health story together.
Rather than looking at one symptom or one test result in isolation, Dr. Hagmeyer evaluates how multiple systems may be interacting.
Dr. Hagmeyer Reviews Your Case Before Your Appointment
Dr. Hagmeyer reviews your file before your scheduled Case Review.
This means your appointment time can be spent discussing the information that matters most rather than simply collecting your history.
Before meeting with you, Dr. Hagmeyer has already had an opportunity to review your:
- Health history
- New Patient Application
- Health narrative
- Food journal
- Previous testing
- Current laboratory results
- Medications
- Supplements
- Primary health concerns
This preparation is an important part of Dr. Hagmeyer’s Big Picture approach.
Before Submitting Your New Patient Application
Please make sure your application includes:
- Completed paperwork
- Recent photo
- Copy of your driver’s license or photo ID
- Copies of relevant previous testing
- Completed health narrative
- Completed 7-Day Food Journal
- Copy of one test you wish Dr Hagmeyer to review.
- Required signatures and dates
Incomplete applications may delay the next step in your evaluation.
Important Paperwork Instructions
Please follow these instructions carefully:
- Do not submit double-sided scans.
- Do not take photographs of completed paperwork.
- Documents should be scanned clearly.
- Please type your health narrative rather than handwriting it.
- Make sure all required signatures and dates are included.
If you do not have access to a scanner, many office supply stores and public libraries offer scanning services.
We Accept a Limited Number of New Patients
Dr. Hagmeyer accepts a limited number of new patients so that sufficient time can be dedicated to reviewing each case and providing personalized care.
New Patient Applications are reviewed in the order they are received.
Submitting complete paperwork and required testing helps prevent unnecessary delays.
Please provide as much detail as possible.
The more information Dr. Hagmeyer has before your evaluation, the better he can understand your history and the patterns within your case.
Ready to Complete Your Moderate Complexity Application?
You can complete the application securely online:
Start Your Moderate Complexity New Patient Application
Or, if you prefer, you can download the PDF version and email it to: drhagmeyerpaperwork@gmail.com
The paperwork for Low and Moderate complexity paperwork is the same.
If you have questions about the application or New Patient process, please contact our office before submitting your paperwork. Be sure not to mail the new patient paperwork
On behalf of Dr. Hagmeyer and the entire DrHagmeyer.com team, we look forward to helping you take the next step toward better understanding your health.