Ask Us Anything Ask Us Anything Please complete the following and we will be in-contact as soon as possible. Full Name Email Address Mobile Number Zip Code Type of inquiry Type of inquiry Curious Future Patient Active Patient Former Patient Visit Type Visit Type Virtual In Person If In-Person, Then Select Preferred Equilibrium Location If In-Person, Then Select Preferred Equilibrium Location Southlake Houston - River Oaks North Dallas – virtual only at the time Frisco – virtual only at the time Fort Worth Reason for contact (select one or more) Reason for contact (select one or more) Weight loss PCOS Thyroid Assessment Hormone Re-Balancing Therapy Type 2 Diabetes / Insulin Resistance Vitamin & Amino Injection / Infusion Therapy Nutrition Consultation & Planning Eating Disorder Evaluation Other Receive Future Communication From Equilibrium Via Email / Text / Phone Receive Future Communication From Equilibrium Via Email / Text / Phone Yes No 11 + 3 = Submit