Dear New Client,

Dr. Elena Klimenko &  Healthy Wealthy & Wise Medical practice welcomes you. In order to expedite your registration process please follow the appropriate link to complete the initial intake form

If you are a Integrative/Functional medicine client please follow the link and complete the appropriate questionnaire and bring it to your first visit with Dr.Klimenko. Allow yourself 45-50 minutes to complete this form.

Functional Medicine Adult Intake Forms

*Please remove nail polish prior to your doctor’s visit!

If you are a Cosmetic client please fill out the attached form and bring it to your appointment.

Cosmetic forms

If you are a Travel medicine client, please fill out this forms and bring it to your visit with Dr.Klimenko.

Dr.Klimenko’s main goal is to provide you with the most updated and efficient way to achieve optimal health. She implements a variety of modalities for your care: from conventional allopathic medicine to acupuncture, homeopathy and functional/nutritional medicine.

Dr.Klimenko spends time working with you on an individual basis in order to provide you with the best possible care. Her services are not covered by in-network medical insurances. However,  Dr. Klimenko will help you to submit a claim to the insurance, if you have out-of network coverage.

The patients would need to pay at the time of services – cash, checks or credit cards are accepted. Dr.Klimenko will provide you with all necessary information to submit for reimbursement.


Online scheduling is for follow-ups only. New patients please call us to make an appointment.