Frequently Asked Questions

Visit frequency depends on your goals, medical history, and how your body responds to treatment. All care is individualized and may change over time.

• When starting most medications, including hormone therapy, follow-up visits are commonly scheduled around 1 month after initiation, then approximately every 3 – 6 months during the first year, depending on clinical need.
• For perimenopause management, symptoms and hormone patterns can shift over time. Many patients benefit from check-ins every 3–6 months during this phase, which may last for 3-7 years (sometimes longer).
• Once a hormone regimen is well established—whether post-menopause, perimenopause or gender-affirming hormone therapy—it may be appropriate to transition to annual visits, provided treatment remains stable.
• Patients prescribed testosterone generally require follow-up visits every 6 months, even when stable, to ensure appropriate monitoring and ongoing safety.

Together, we will determine a follow-up schedule based on current evidence, clinical considerations, and your preferences. Visit frequency may be adjusted as needed.

Laboratory testing is ordered only after a clinical visit, and only when it is medically appropriate and relevant to your care. Not all visits require labs.

When labs are ordered:

• You are typically advised to schedule a follow-up visit 1-2 weeks after labs are drawn to review results and discuss next steps.
• If lab results are within expected ranges and no changes to care are needed, a follow-up visit may not be required.

Lab costs are separate from visit fees and are paid directly to the laboratory. These also may be covered by your insurance provider; you are encouraged to reach out to your provider to confirm.

Prescriptions are provided only after an appropriate clinical evaluation and when medically indicated. Prescribing decisions are based on current evidence, clinical guidelines, and individual health history and needs.

Medication initiation, continuation, or renewal may require follow-up visits and/or laboratory monitoring. Prescriptions are not guaranteed and are always part of a shared decision-making process.

Prescription renewals generally require an active patient relationship and may require a visit, depending on the medication, time since last evaluation, and clinical circumstances.

• Brief renewal visits (20 minutes) may be appropriate for stable patients with an established care plan.
• Some medications, including testosterone, require regular follow-up visits at least every 6 months and monitoring to continue prescribing safely.

All visits are conducted via secure telehealth unless otherwise specified.

Patients are expected to:

• Be physically located in a state where I am licensed at the time of the visit
• Join visits from a private, safe location where sensitive health information can be discussed
• Have a stable internet connection and a device with audio and video capability

Telehealth may not be appropriate for all clinical situations. In some cases, in-person care or referral to another provider may be recommended.

Yes, the patient portal can be used for non-urgent communication.

Simple questions or administrative messages are welcome. If your message requires clinical evaluation, review of records, or changes to your care plan, you may be asked to schedule a visit or an asynchronous clinical review.

Asynchronous care allows for established patients to ask focused clinical questions to be addressed through the patient portal without a scheduled visit.

This may include lab review, minor medication adjustments, or follow-up questions related to a visit that was more than 14 days ago, and when you do not have an upcoming visit scheduled within the next 14 days.

Asynchronous clinical review is $50 - $75 depending on complexity. More complex concerns may require a scheduled visit.

I aim to provide thoughtful, individualized care, which often requires dedicated time. For this reason, most clinical concerns are best addressed through visits or structured clinical review.

I do not bill insurance. A deposit is due at time of booking and full payment is due at the time of service.

I can provide a superbill that you may submit to your insurance for possible reimbursement.

I may also be able to accept FSA cards, depending on your plan’s requirements.

Due to federal regulations at this time, I am not allowed to accept patients with Medicare or Medicaid insurance, even if they are willing to pay cash for services. If you need recommendations of where you can go for this care, please let me know.

This practice focuses on patients aged 35-65, though certain exceptions may apply. I am unable to see patients under 19 years old.

Yes. This practice provides specialty hormone and sexual health care and does not replace primary care.

I recommend maintaining an ongoing relationship with a primary care provider for preventive care and general health needs. I am happy to communicate and collaborate with your primary care provider as needed.

Monarch came to me as a classic symbol of beautiful transformation, but also from the incredible migratory journey monarch butterflies undertake, and the idea of setting intention as we head forward on our own unknowable path into the future.

West because that’s where I’ve moved and because to me it represents the future time horizon.

Monarch West—what beautiful things await on your journey ahead?