Weight management request

Request care

Tell us a little about what you need. A member of our team follows up during clinic hours.

Full name

Email address

Phone (optional)

State you live in

What would you like help with?

Weight loss support

Metabolic health

Prediabetes or type 2 diabetes

Blood pressure

Sleep apnea

PCOS

Nutrition guidance

Movement and activity

Interested in GLP-1 options

Maintaining recent progress

Best way to reach you

Anything you would like us to know (optional)

Attach documents (optional)

Insurance card, referral, lab results or medication list. PDF, JPG or PNG up to 10 MB each. Files go to private quarantine storage and are not opened by staff until checks finish.

I understand this form is not for emergencies, that the information I share is used to arrange care, and that submitting it does not create a patient relationship or provide a diagnosis. Read our privacy and use policy.

This form is not monitored for emergencies.

Wellness & Balance LLC

Weight management, primary care, and mental-health support from one Chesapeake practice led by Mrs. Angel Williams-Kent, APRN, FNP-C.

Visit

111 Mill Creek Parkway Ste 102, Chesapeake, VA 23323

757-469-1452
Fax 757-956-5073
healthyminds@healthyminds355.net

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Privacy & disclaimers

This website provides general health education and clinic-navigation information. It is not a diagnosis, treatment plan, or medical advice, and it does not create a patient-provider relationship. A licensed clinician confirms anything consequential for your care.

In an emergency call 911. For emotional distress or suicidal crisis, call or text 988. Messages and appointment requests sent through this website are not monitored as emergency or crisis services.