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Diane Culik MD

Virtual Holistic Medicine   

Simple Steps to Better Health




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ABC Wellness



New Patients Must Print and Complete These Forms

Schedule an Appointment with Dr. Culik BELOW.




Please Print All:  
Demographic, Telemedicine Consent, 
New Patient History Form, Virtual Medicine Agreement
and Medical Release Forms and Complete

Then FAX to 888-480-3870 or
email to

Please Complete either of These Below if:

1. You Have Medicare


2. You Need more space for Supplements

Learn More From Diane Culik MD

Check out Dr. Culik's online books on Amazon including information on:


Natural Thyroid, Adrenal Health, Bio-Identical Hormones, Weight Loss,

Acid Reflux, How to Live to 100, Gut and Gum Health and More.



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