Your secure intake forms are embedded right here on this page — no downloads, no email links. Just fill them out below in 10–15 minutes using any phone, tablet, or computer.

Start typing in the form fields below.

Red asterisk (*) = Required — these must be filled in.

No asterisk? → Optional — skip if you’re unsure.

Don’t know the answer? Simply leave it blank or write “N/A” — we’ll cover it in your virtual consult.

Scroll down and click “Submit” when finished.

IF YOU'RE ON YOUR MOBILE PHONE, TAP HERE TO OPEN THE FORM IN A NEW TAB

After You Submit:

Final Step: Check your inbox (and spam/junk folder) for a verification email from adobesign@adobesign.com. Click the “Confirm My Email Address” button to electronically sign and finalize your forms. This step is required to complete registration.

You’ll automatically receive a signed, completed copy of your forms sent directly to the email you provided — instantly and securely.

Our team will review your submission, and a board-certified physician will contact you within hours to schedule your virtual consultation.

Need help? Email info@increasemyt.com — we’re here to support you every step of the way.