Join the Waiting List

WANT TO BECOME A PATIENT?

Please complete the form below to join the waiting list. We are currently contacting individuals in the order they joined, on a first come, first served basis. While we can’t predict exact timing, availability typically opens within 1–2 months. We’ll reach out as soon as a spot becomes available.

Thank you for your patience!

First name*

Last name*

Email*

Phone*

ZIP Code*

Preferred Contact Method*

Phone Call

Text Message

Best Time of Day to Contact You?*

Morning (8AM - 11AM)

Early Afternoon (11AM - 1PM)

Late Afternoon (1 PM – 4 PM)

Do you have a primary care physician?*

Yes

Not right now

Other

What brings you to functional medicine?*

Chronic symptoms or diagnosis

Hormonal imbalance

Gut health or digestive issues

Fatigue or burnout

Preventative/wellness care

Pediatric care

Other

I am aware that you are a cash-pay practice and do not accept insurance. We do accept HSA and FSA.

I consent to be contacted by Partnered Healing Functional Medicine regarding this inquiry with the provided contact information.

Yes, I’d like to subscribe to receive occasional emails about wellness tips, events, and updates from Partnered Healing Functional Medicine. I understand I can unsubscribe at any time.

HOURS

Monday - Thurs 8AM – 4:00PM
Friday: 8AM – 12:00PM
Saturday: Closed
Sunday: Closed

(937) 863-1003

8534 Yankee Street suite 2d, Dayton, OH 45458, USA

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