We are passionate about helping you achieve your ultimate wellness through healing of underlying health issues. At Heal n Cure, we have assisted thousands of practice members to reach their health goals through our unique integrative functional medicine approach.

We welcome you to our collaborative care where we will teach you how to develop the tools that will maximize your wellness goals and enable you to take ownership and control of your own health. Welcome to our refreshing approach to patient care through functional medicine.

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What is functional medicine?

At Heal n Cure, we utilize an integrative multicomponent method which assures that each patient is comprehensively evaluated. Our program targets the underlying causes of a person’s health issues and addresses all foundation pillars of a health through our curriculum style pathway. This refreshing use of Functional Medicine breaks away from disease-centered care that fails to address these underlying concerns or to allow full healing.

Our practitioners work in partnership with our practice members to create and carry out personalized care. This hand in hand approach leads to a reverse in the risk of acute and chronic medical conditions, helping thousands of our practice members to feel, live, and look their best. Only with our patient centered approach can we find the answers to these root problems and help our patients on their journey to true wellness.

Building Blocks of Functional Medicine

Patients First

Our practitioners work collaboratively and closely with our practice members to learn their health story through a comprehensive interview process and proper test evaluation. Being “disease free” is not our goal for our members, but instead, to live with vitality, to feel wellness, and look their best by treating the underlying health issues and tailoring a care plan with the individual patient.

Science Led

Thoughtfully developed testing and review combined with a thorough understanding of the health history and current environmental influencers are tools we combine to work through the foundation pillars of health and reach a goal of healing and vitality. The unique biochemical makeup of each individual is the key to our functional medicine strategy that continues to help thousands of practice members each year.

Integrative

By addressing the building blocks of health through our foundation approach, we address not just one symptom, but instead look at nutrition, detoxification, physical, emotional and environmental stressors, fitness, and hormonal restoration to truly build a care program that fosters healing and wellness. This Integrative method is the reason we are able to address and heal the root issues and maximize wellness and vitality through collaborative care with each team member.
 

THE PROBLEM

Why do we need functional medicine?

  • Weight Loss:

    Weight gain can be both the cause of other disease states and it can also be a symptom of underlying health issues. This is why the Functional Medicine approach is the key to helping individuals reverse weight gain while developing the tools to create and maintain a healthy balance.

  • Diabetes: 

    One in two people with diabetes is undiagnosed. However, early intervention has proven to prevent or delay the onset of diabetes while enhancing lifespan. Delaying the onset of diabetes substantially reduces the incidence of vascular complications, improve quality of life.

  • Heart Health: 

    Heart disease remains a number one killer in The United States. It is also a major cause of disability. Heart diseases comes in many forms. Nine out of ten heart disease patients have at least one risk factor. Our integrative approach to core wellness targets improvement of all of heart related health risk factors.

  • Hormonal Balance: 

    By age 50, we are at approximately 50% of hormone function for estrogen, progesterone, testosterone, thyroid, DHEA melatonin and growth hormone. By utilizing testing and treatment to help you regain that balance, unwanted symptoms of hormone depletion and aging can disappear!

At Heal n Cure, we implement the latest research and science into our treatment plans.

5 PILLARS of health

5 Pillars of wellness

Medication Histroy

Your Wellness Journey Starts here.
  • Please check any of the following medications you have taken in the past or are currently taking.
  • Date Format: MM slash DD slash YYYY

Metabolic Detoxification Questionnaire

Your Wellness Journey Starts here.
  • Point Scale
    • 0 - Never or Almost never have the symptoms
    • 1 - Occasionally have it, effect is not severe
    • 2 - Occasionally have it, effect is severe
    • 3 - Frequently have it, effect is not severe
    • 4 - Frequently have it, effect is severe
      • Date Format: MM slash DD slash YYYY
      • Head

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Eyes

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Ears

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Nose

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Mouth / Throat

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Skin

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Heart

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Lungs

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Digestive Tract

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Joints/ Muscles

      • Weight

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Energy/ Activity

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Mind

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Emotions

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Other

      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.
      • Please enter a number from 0 to 4.

Neurotransmitter Assessment Form

Your Wellness Journey Starts here.
  • Date Format: MM slash DD slash YYYY
  • SECTION A

    Select any one option on a scale : 0 being Never to 3 being Always
  • SECTION B

  • SECTION C

    Section C1
  • Section C2
  • SECTION D

  • SECTION E

  • SECTION F

  • SECTION G

Financial Policy Consent

  • FINANCIAL POLICY

  • It is your responsibility to know if your insurance has specific rules or regulations,such as the need for referrals,recertification's, preauthorization's, limits on outpatient charges, specific physicians and/or hospitals to use. You should be knowledgeable of any deductibles, copayments, and/or coinsurance. This applies to all payers regardless of whether or not our physicians participate.
  • The responsibility for payment of fees for services is your direct responsibility. Your health benefit plan is an arrangement between you,the enrollee, and the insurance company or your employer. We will do our best to assist you with understanding your proposed treatment and in answering questions related to your insurance.

    Please check all boxes below to acknowledge you have read the financial policy
  • Payment Policy Schedule


  • Other charges/fees*

  • *subject to change at any time


  • We require you to provide us with 24 hour notice for prescription refill during the weekday. The requests made over the weekends and holidays will be filled the following business day. we need minimum of five day notice to fill out any paperwork.

    Should you have any questions with regard to our financial policy we encourage you to ask.

    We ask that you present the correct and updated contact and medical insurance information at the time of each visit. Please notify the receptionist of any changes during the subsequent visits promptly.
  • Date Format: MM slash DD slash YYYY

Hormone Deficiency Assessme

Your Wellness Journey Starts here.
  • Date Format: MM slash DD slash YYYY
  • Fill up the details promptly below so as to analyze if you need any treatment related to hormone deficiency.
  • TESTOSTERONE

  • Signs and symptoms ( Men and Women )
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
  • Signs and symptoms ( Men Only )
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
  • Score for Women: [5 or less : Satisfactory level] [6-10 : Possible Testosterone deficiency] [11 or more : Probable Testorsterone deficiency ] Score for Men: [ 10 or less: Satisfactory level ] [ 11 to 20 : Possible Testorsterone deficiency ] [ 21 or more : Probable Testorsterone deficiency ]
  • ESTROGEN

  • Signs and symptoms
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : (0=moderate I 1-3=1ow / 4=none)
    Select any one option on a scale : (<27 days),or too long (>31 days)
    Select any one option on a scale : 0 being Never to 4 being Always
  • The overall total of 10 or less is satisfactory level. Between 11-20: Possible Estrogen deficiency. 21 or more: Probable Estrogen deficiency.
  • PROGESTERONE

  • Signs and symptoms
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
  • [The following questions are for women who have not yet reached menopause, and menopausal women who are taking hormone replacement therapy (estrogen or estrogen and progesterone).]
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
  • Post-menopausal women not treated with hormone replacement therapy (estrogen or estrogen and progesterone): 4 or less: Satisfactory level. Between 5 and 8: Possible Progesterone deficiency. 9 or more: Probable Progesterone deficiency ------- Menstrual women and menopausal women taking hormone replacement therapy (estrogen or estrogen and progesterone): 10 or less: Satisfactory level. Between 11 and 20: Possible Progesterone deficiency. 21 or more: Probable Progesterone deficiency
  • THYROID

  • Signs and symptoms
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
  • The overall total is 10 or less is satisfactory level. Between 11-20: Possible Thyroid Hormone deficiency. 21 or more: Probable Thyroid Hormone deficiency.
  • DHEA

  • Signs and Symptoms ( Men and Women )
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    (0 = plenty of hair/ 4 = hairless)
    (flat "mound ofVenus" in women). (0 = padded/4 = flat)
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
    Select any one option on a scale : 0 being Never to 4 being Always
  • The overall total is 10 or less is satisfactory level. Between 11-20: Possible DHEA deficiency. 21 or more: Probable DHEA deficiency

Impact of Medical Conditions

  • Impact of Medical Conditions on Your Life

  • Date Format: MM slash DD slash YYYY
  • How does this problem interfere with the following areas in your life?

  • Rate on a scale of 1-10

Patient Registration


  • Employment Information:


  • Emergency Contact :



  • Secondary Emergency Contact :



  • Primary Care Provider (PCP) :


Get Relief Now

  • Date Format: MM slash DD slash YYYY
    ( Check all that apply )

HIPAA Consent

  • Heal n Cure, SC www.healncure.com
    Meena Malhotra, MD Phone: 847-686-4444 Fax: 847-686-9999
  • I hereby acknowledge the receipt and complete understanding of Notice Of Privacy Practices of Heal n Cure, SC which provides detailed information about how the practice may use and disclose my confidential information.
    I understand that Heal n Cure has reserved the rights to change its privacy practices that are described in the Notice. I also understand that a copy of any revised notice will be provided to me or made available at the subsequent visit to the clinic.
  • Date Format: MM slash DD slash YYYY
  • If you are not the Patient, please verify your relationship to the patient.

  • Date Format: MM slash DD slash YYYY