6822 E 82nd Street #310, Indianapolis IN 46250
contact@mytrimmd.com 317-548-4666 646-362-1349
OUR REVIEWS

Patient Forms

fitwell

Once you have confirmed your appointment date, you’re welcome to download the appropriate intake forms to fill out ahead of your visit.

These forms may include a number of questions addressing diet, lifestyle, past medical history, and family medical history. They also include consent and release forms.

Please take the time to fill these out completely.

Bring these completed, signed intake forms when you come for your first appointment. This will save you time and ensure that your treatment starts on time.

STEP 1: Download the file into your device. See our how-to-download video (on a Mac) below.

STEP 2: Open the file and fill it out. And then SAVE (click the SAVE button shown in the image below or for some devices, you may have to click the DOWNLOAD button again).

Step 3: Email the filled out form to contact@mytrimmd.com via email attachment.

Medical Weight Loss Appointment:

Weight Loss Intake Form

Body Contouring and Aesthetics Appointment:

Body Contouring Intake Form

Bio-Identical Hormones:

For Women:

Women Bio-Identical Hormone Intake Form

For Men:

Men Bio-Identical Hormone Intake Form

Hair Loss Appointment

Hair Loss Intake Form

Sexual Wellness:

For Women:

Women sexual wellness Intake Form

For Men:

Men sexual wellness Intake Form

Patient Resources

Proudly Serving Indianapolis, Carmel, Fishers, Noblesville And Surrounding Areas

Contact Us
 Office Hours
  • Monday
  • Tuesday
  • Wednesday
  • Thursday
  • Friday
  • 10am – 6pm
  • 10am – 6pm
  • 8am – 4pm
  • 10am – 6pm
  • 8am – 4pm

*Disclaimer: The information on this website is provided for general informational and educational purposes only and is not intended as medical advice. Content on this site is not a substitute for professional diagnosis, treatment, or medical decision-making.

*Photos and testimonials are for illustrative purposes only. Individual results vary.