Young Foundational Health

Contact Young Foundational Health

Thank you for your interest in booking a New Patient Appointment at Young Foundational Health Center. Please fill out the form below. All fields are required. (only new patients)

Full Legal Name:

Please type your full name.

Address:

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City:

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State:

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Zip Code:

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Phone Number:

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Date of Birth:

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Chief Complaint: (Why you are coming in)

Please let us know why you would like to schedule an appointment with Alex.

E-mail:

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Insurance Provider*:

Please include your insurance provider.

*If you don't have insurance, please put self-pay.

If you are coming into our office, please let us know if you have tested positive for COVID at any point in the past 4 weeks?

yesno

Please answer yes or no.

Please bear with us as we return calls and emails to everyone that has contacted us. In the meantime please subscribe to our YouTube channel with Alex and Dr. Young and get to know our providers.