To get started, we will need you to provide us with detailed patient information.

Please print and complete a Patient Intake Form and a Patient History Form. Both are available in English and Spanish.

Please email completed forms to

Assessment Quiz.

The following quiz is designed to help you assess your general wellness and lifestyle choices.
Answer honestly and skip any questions which do not apply or with which you are uncomfortable.

Are you tired all of the time?

Are you constantly in pain?

Do you take multiple medications?

Is your belly getting larger?

Are you stiff and lack flexibility?

Do you have a chronic disease?

Do you have an unhealthy diet?

Do you have trouble sleeping?

Do you live with high levels of stress?

Have you had cancer?

Do you currently have cancer?

Are you an insulin dependent diabetic?

Do you suffer from arthritis?

Would you like to look younger?

Do you want a healthier lifestyle?

Are you an athlete looking for an edge to help you continue to participate at an elite level and hopefully add years to your performance?

If you answered "Yes" to any of these questions, please click here to schedule a consultation appointment.
Click here for a printable .pdf of the questionnaire.

Want to know more about Glenn C. Terry, M.D?  Click here! 

Watch the "Ask the Doctor Videos" Click here!