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Diane Culik MD
Virtual Holistic Medicine
Simple Steps to Better Health
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Regarding
ABC Wellness

New Patients Must Print and Complete These Forms
Schedule an Appointment with Dr. Culik BELOW.
(Please Print the Demographic, Telemedicine Consent, and the New Patient History Form 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
or
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.