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Forms
Intake Form for Initial Consults Only
Our intake form is long and detailed and will take some time to complete. This PDF form can be filled out online or printed and scanned then emailed to drlisajamesphd@gmail.com. It’s important that you answer the questions with detail and accuracy.
All pages must be filled out in entirety and emailed three (3) business days prior to your first scheduled appointment. If forms are not received or completed and signed, you will need to forfeit your appointment and reschedule. In order to properly do an intake, I will need all information, as this benefits you in order to receive proper recommendations.
Outside Lab Interpretation Services
Functional Lab Analysis
The Consent form must be filled out if you are doing either one of the Lab Interpretation Services.
You can email your labs and signed/dated consent form to me at drlisajamesphd@gmail.com
Service will not be done until I receive the Consent form.
Beyond Normal: Understanding What Your Labs Are Really Saying.
Most conventional lab work is reviewed only to determine whether you have a diagnosable disease.
But what about the gray area between “normal” and “optimal”?
In this service, I analyze your existing labs through functional medicine terms to identify patterns, imbalances, and early dysfunction — before they become a diagnosable disease.
What This Includes:
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Review of labs ordered by your physician
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Comparison of conventional vs functional optimal ranges
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Pattern recognition (thyroid, blood sugar, iron, inflammation, liver, hormones, immune markers, etc.)
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Written summary report
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60-minute call on Comprehensive multiple lab service analysis
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Suggested follow-up lab recommendations (if needed)
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What This Is Not:
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A medical diagnosis
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A replacement for your physician
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Medication management
This service bridges the gap between “You’re fine” and “You don’t feel fine.”
This interpretation is educational only and is not intended to diagnose, treat, or replace your physician’s care
Functional Skin Wellness Consult Intake
I recommend and use Oliveda products because they are formulated with high-quality, antioxidant-rich olive tree extracts and botanical ingredients selected to nourish the skin, and support the skin's natural health and barrier function.
Please complete the Functional Skin Wellness Intake in detail. This PDF form is fillable online, then save to your computer and email or printed and scanned then emailed to drlisajamesphd@gmail.com. It’s important that you answer the questions with detail and accuracy.
All pages must be filled out in entirety and emailed two (2) business days prior to your first scheduled appointment. If forms are not received or completed and signed, you will need to forfeit your appointment and reschedule. In order to properly do an intake, I will need all information, as this benefits you in order to receive proper recommendations.
To help create the most personalized skincare experience possible, please complete the Ask Olive Brain skin assessment prior to your consultation. Your responses provide additional insight into your skin's unique needs and, combined with our one-on-one discussion, help guide tailored Oliveda product recommendations designed specifically for you.
Important Note
I am a Doctor of Functional Medicine (DFM, PhD), not a licensed aesthetician or dermatologist. My recommendations are based on a functional medicine approach that considers nutrition, lifestyle, hormones, gut health, inflammation, and overall wellness in addition to your skincare goals.
This consultation is intended to help identify skincare products that may support healthy skin. It is not intended to diagnose, treat, or manage medical skin conditions. If you have a persistent or concerning skin condition, I recommend consulting a licensed dermatologist or your healthcare provider.