The $35 Consultation - What Happens and Why It Matters

Key takeaways

• The $35 consultation is a 30 to 45 minute visit covering your symptom history, a focused exam, and deep lab orders.
• The $35 is credited toward your treatment plan if you move forward; labs are billed separately, often $200 to $600.
• Results are read against optimal ranges, not just the wide "normal" range used to screen for disease.
• Hormone patients get a tailored men's or women's panel and a follow-up lab check 4 to 6 weeks after starting.
• No referral is needed, fasting is not required, and telehealth follow-ups are available.

A new-patient visit at Arbour Longevity costs $35 and lasts 30 to 45 minutes. For many people it is the most useful appointment they will book all year. It looks at why you feel the way you do, measured against optimal ranges, not just a quick screen for disease.

Short answer: The $35 consultation is a 30 to 45 minute visit. We listen to your full symptom story, do a focused exam, and order the right deep lab panel for your situation. The $35 is credited toward your treatment plan if you move forward. Labs are billed separately.

Before your first visit: what to prepare

There is no special preparation. Bring:

• A list of your current medications and supplements.
• Any recent lab results from your primary care provider, or any imaging.
• A clear idea of which symptoms bother you most.
• Anything you have been tracking, such as sleep, energy or menstrual cycles. That data is useful.

Fasting is not required for the consultation itself. If full lab work is drawn on the same visit, your clinician may suggest fasting for the most accurate metabolic results. You do not need a referral. Arbour Longevity is an independent clinic, and we accept patients directly. If you have no recent labs, we start the workup from scratch.

What happens during the $35 consultation

Here is the visit, step by step:

• A real conversation about your history and the symptoms bothering you, not a paperwork drill. It covers your symptom timeline, family history, past treatments and supplements, and lifestyle factors such as diet, exercise, sleep and stress.
• Your mental health history, because hormones and mood are deeply connected. Your clinician is board certified in both family practice and psychiatric mental health, so nothing gets compartmentalized. If your fatigue has a hormonal root but your anxiety has worsened alongside it, both are addressed together.
• A focused physical check related to your concerns.
• Orders for a deep lab panel. Depending on your case, that can include a full hormone workup, a complete thyroid panel, metabolic markers like fasting insulin, inflammation markers, and nutrition markers.
• A plain explanation of what we are looking for and how the results will shape your plan.
• An overview of options that may fit: hormone therapy, peptides, medical weight loss, regenerative procedures, aesthetics, IV therapy. This is a good moment to raise the 5 questions worth asking before starting any aesthetic or wellness treatment.
• A clear next step: when to get labs drawn, when to return, and what treatment usually looks like.

Your clinician is Gandhi Bhattarai, FNP-BC, PMHNP-BC, Anti-Aging/Functional Medicine BC. This is not a five-minute intake form review.

Why it looks different from a primary care visit

A typical primary care visit is about 15 minutes. Its job is to catch disease and manage what insurance covers. That is essential. But it is not built to explain a healthy-looking 42-year-old who is exhausted, foggy, and 18 pounds heavier than two years ago. Her standard labs all read "normal," and a 15-minute visit has no answer for that.

A longevity visit asks a different question. Where is the gap between how your body should be working and how it is actually working, and how do we close it? That means a longer visit, a deeper set of questions, and a broader lab panel. Results are read against optimal ranges (what is ideal for how you feel), not just the wide "normal" range. If your labs keep coming back normal while you feel terrible, our piece on why that happens explains the difference. For more on the testing itself, see the 5 blood tests your doctor is not ordering.

The five lab areas we order most often

Depending on your symptoms, the visit usually generates orders in some mix of these areas.

• Hormones: total and free testosterone (the main male sex hormone; women make it too, in smaller amounts) and SHBG (a protein that holds onto your hormones). Also estradiol (the strongest form of estrogen), progesterone (the hormone that balances estrogen), DHEA-S (an adrenal hormone), prolactin, FSH and LH.
• Thyroid (the gland that sets your metabolic speed): TSH, free T3, free T4, reverse T3, and thyroid antibodies.
• Metabolism: fasting glucose, fasting insulin, HbA1c (a 3-month blood-sugar average), and a full cholesterol panel.
• Inflammation: hs-CRP (a blood test for inflammation), homocysteine, and ferritin.
• Nutrition: vitamin D, B12, folate, and magnesium.

For some patients we add markers like PSA (a prostate screening test) for men over 40, or advanced heart markers for those with a strong family history. The panel is matched to you. Nothing relevant is skipped because of insurance.

Wondering what this costs?
The visit is $35, credited toward your plan if you continue; labs are billed separately, and we only order the ones your case calls for.
Book your $35 first visit Call (734) 436-3357

If you are coming for hormone therapy

Hormone decline is not just a menopause issue. It is not just an andropause (age-related testosterone decline in men) issue either. Men and women in their 30s, 40s and 50s increasingly notice symptoms that trace back to suboptimal hormone levels. Common reasons people book a hormone visit include:

• Persistent fatigue that sleep does not fix.
• Unexplained weight gain, especially around the midsection.
• Trouble concentrating, or brain fog.
• Lower libido (sex drive) or sexual function.
• Irritability, anxiety, or mood changes.
• Thinning hair, dry skin, or slow recovery from exercise.
• Poor sleep quality despite good sleep habits.

Ann Arbor has several clinics that offer hormone services. It matters to find one whose clinician is board certified in both primary care and functional or anti-aging medicine. That combination means your provider sees the full clinical picture instead of treating one lab number on its own. Here is how the visit works for you at Arbour Longevity in Ann Arbor.

The hormone lab panel

Hormone therapy without proper lab work is guesswork. The panels go well beyond what most annual physicals include.

• For women: estradiol, progesterone, total and free testosterone, DHEA-S, and a thyroid panel (TSH, free T3, free T4, thyroid antibodies). Also cortisol, fasting insulin, HbA1c, a complete metabolic panel, CBC, and vitamin D.
• For men: total and free testosterone, estradiol, SHBG, PSA, DHEA-S, thyroid function, metabolic markers, and CBC.

The goal is to see where you actually are, not just whether you fall inside a broad reference range. Optimal and normal are often very different. A clinician trained in anti-aging and functional medicine knows the difference.

Matching symptoms to labs

Once results are in, you return for a review visit. This is where the real clinical work happens. Your clinician maps your symptoms to your lab values and identifies which hormones are suboptimal. Then your clinician decides whether hormone therapy is the right approach, or whether other steps such as nutrition changes, stress management or thyroid support should come first.

Treatment options if hormone therapy fits

Arbour Longevity uses bioidentical hormones (the same molecular structure as the hormones your body makes). Delivery options include:

• Topical creams and gels, which give steady daily dosing and are easy to adjust.
• Injectable testosterone or other hormones, for patients who prefer less frequent dosing.
• Hormone pellets (rice-sized implants placed under the skin) every three to six months, for the most consistent levels.
• Oral or under-the-tongue forms when appropriate.

There is no one-size-fits-all protocol. Your plan is based on your labs, your symptoms, your lifestyle, and your goals. Some patients do well with testosterone alone. Others need a broader plan that includes thyroid support, adrenal balancing, or metabolic care alongside their hormones.

Follow-up and monitoring

Starting hormone therapy is not set-it-and-forget-it. For hormone therapy, follow-up labs are usually drawn four to six weeks after starting treatment, so your clinician can see how you are responding and fine-tune the dose. After that, most patients settle into a quarterly or twice-yearly lab schedule. Hormone levels shift with stress, sleep, body composition and aging, so a clinician who actively manages your protocol gets better long-term results than one who just refills prescriptions. For the week-by-week picture of what improves and when, see how long hormone therapy takes to work.

Hormone therapy is not right for everyone, and a responsible clinician will say so upfront. Reasons to avoid it, personal risk factors and your goals all factor in. The $35 consultation is built to answer exactly this question with no pressure and no upselling. If hormone therapy is not the right fit, your clinician will recommend the approach that is.

Lab costs and the fee

The $35 covers the provider visit. Labs are separate and depend on what is ordered, often $200 to $600 out of pocket. HSA and FSA cards cover lab costs. If you proceed with treatment, the $35 is credited toward your first program.

What I see in clinic

The most common new patient has already done the rounds: a primary care visit, one basic panel, and the advice that everything looks fine. They still feel off, and they are not imagining it. Once we run the deeper panel and read it against optimal ranges, there is almost always something to act on. It might be a thyroid pattern, low iron stores, or a hormone shift. The relief on people's faces when their experience finally lines up with a number is the reason this visit exists.

What the second visit looks like

Two to four weeks later, once labs are back, we design the plan. We walk through every marker, point out what is optimal and what is not, and build a tailored plan from there. That may include hormone therapy, peptides, medical weight loss, regenerative procedures, aesthetics, or lifestyle changes. Improvements in energy, sleep and mood often show up within 2 to 4 weeks of starting, with body-composition shifts over 3 to 6 months. For other programs, follow-up labs are usually repeated at 6 to 12 weeks, then a couple of times a year.

To understand our overall approach, see longevity medicine versus functional medicine and how Arbour is different from a med spa. Our longevity medicine program is built around that same ongoing tracking.

Frequently Asked Questions

Is the $35 fee really credited to my first program?

Yes. If you proceed with treatment, the $35 is applied to your first month or first program charge.

How soon can I be seen?

We aim to schedule new consultations within 1 to 2 weeks. Same-week visits are sometimes available.

Can I bring my partner?

Yes. Many patients bring a partner, and we are happy to accommodate that.

Do you accept insurance?

Arbour is a self-pay practice. Most longevity, regenerative, and aesthetic services are not covered by standard insurance. We accept HSA, FSA, credit cards, and Klarna/Affirm financing.

What if my labs come back normal?

A deep panel rarely comes back fully optimal across every marker for someone who feels unwell. Normal by reference range is not the same as optimal for how you function. We walk through your results and the gap, if any, between where you are and where you want to be.

Can I bring records from my primary care doctor?

Yes, and it helps. We review whatever you have. If your existing labs were thorough enough, we may not need to repeat them, though usually a few extra markers are needed.

Do I need to fast?

Not for the consultation. If labs are drawn the same day, fasting gives the most accurate metabolic results, so your clinician may ask you to.

Where is the clinic, and who do you serve?

2217 Packard St #15, Ann Arbor, MI 48104, with free parking. We serve Ann Arbor, Washtenaw County, and the wider Southeast Michigan area, with telehealth follow-ups available. Hours: Thursday through Monday, 10am to 7pm.

The next step

If something has been off and the standard workup did not explain it, the $35 consultation is built for exactly that. Thirty to forty-five minutes with our clinician, the right lab orders, and a real plan. Book your $35 first visit online or call (734) 436-3357.

Arbour Longevity, 2217 Packard St #15, Ann Arbor, MI 48104. (734) 436-3357. Thursday through Monday, 10am to 7pm.

This article is educational and does not replace individualized medical advice. Results vary.