Honest Family Medicine Contact/Waitlist Form
Honest Family Medicine is a Direct Primary Care Clinic in Cottleville, MO. Dr. Mitchell and her staff are working hard to provide the most comprehensive, affordable and personalized care possible for their patients. In order to ensure appointment availability and to provide the time and attention that each patient deserves, sometimes this means that we close enrollment for new members for a while. The purpose of this form is to notify us of your interest in joining Honest Family Medicine so that we can contact you when enrollment opens.

If you have questions about the clinic before joining the waitlist, please complete the contact form on our website first so that we may answer them. 
Thanks so much for your interest!

Please note that when it is time to reach out to you, we will send you an email from enrollment@honestfamilymed.com. If we don't get a response after 2 attempts to contact you, we will move on to the next person on the list. 

Email *
First Name *
Last Name *
Phone Number *
How did you hear about Honest Family Medicine? *
Required
Are you familiar with the Direct Primary Care concept? *
Please share the name of your friend, family member or acquintance that told you about us! (optional)
How many members of your family (including yourself) are you hoping to enroll with Honest Family Medicine? *
Do you currently have a primary care physician?
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Is there anything in particular you are hoping to get help with upon enrollment? *
If it looks like it may be a while until we can add you to the clinic for primary care, would you be interested in a functional medicine consultation + follow-up for your particular issue without enrolling for primary care (examples include MTHFR testing, comprehensive gut analysis or hormone testing)? *
Please be aware that Honest Family Medicine requires at least one adult to enroll with a child.  This is because we value the family unit as a whole and understand that the genetics, illnesses, goals, home environment and relationships within a family are very important for comprehensive healthcare. *
Direct primary care clinics like Honest Family Medicine are an affordable and convenient way for business owners to provide health benefits to their employees.  You do NOT have to use those big name insurance companies that profit off of YOU just to take care of your employees.
Are you a business owner that is interested in learning about healthcare options that are much more affordable than traditional insurance plans?
 *
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