REALM operates on a cash-pay model — a deliberate structural choice, not a pricing philosophy. It gives each visit the time and continuity this stage of life calls for.

Why Cash Pay?

Yes. REALM is here to give this stage of life the attention it doesn't always get — not to replace your PCP. Think of REALM as a focused, in-depth complement to that relationship.

We do not perform OB/GYN well woman examinations.

A discussion about hormone therapy and whether it's right for you is always part of the conversation. It's never assumed, defaulted to, or pushed — it's one evidence-based option among several, guided by current clinical research and including treatments used off-label when the evidence supports it. The decision is always made together, based on your history, your goals, and your comfort level.

REALM does not offer hormone pellet therapy. We use formulations that allow for precise, adjustable dosing, guided by current clinical research and evidence-based practice — including treatments used off-label when the evidence supports it.

Sometimes. Lab work is used when it's medically indicated for your specific situation — not as an automatic step for every visit. Whether testing makes sense depends on your history, your symptoms, and what you and your provider decide together.

Not at this time — all REALM visits are currently held in person.

InBody is a medical grade body composition analysis that has been validated to gold standard methods — a quick, non-invasive test that measures things a scale can't, like muscle mass, fat mass, water balance, and visceral fat. During midlife, hormonal shifts can change body composition in ways that aren't always reflected on a scale, so this gives us a clearer, more complete picture of what's actually happening and how to guide your care.

https://inbodyusa.com

For the most accurate results, avoid eating or drinking heavily in the 3–4 hours before your scan, skip caffeine and alcohol, and avoid intense exercise for several hours beforehand. You'll also want to wear light clothing and remove jewelry, since the scan works through direct skin contact. We'll walk you through anything else you need to know when you arrive.

Yes. If you're only interested in the body composition scan and interpretation, you can book that as a standalone appointment — no full consultation required.

If you cancel your appointment at least two business days in advance, you will receive a 50% refund of your consultation fee, and the remaining 50% will be held as a credit toward a future appointment for up to one year. Rescheduling at least two business days in advance is free. Cancellations made less than 48 hours before your appointment are not eligible for any refund or credit.

Collecting payment when you book helps us keep a predictable, unhurried schedule — because we're a private-pay practice, we don't overbook or rush visits to make up for late cancellations. This means the time set aside for your appointment is truly yours, and it helps us stay available and on time for every patient. We appreciate your understanding — it's a small step that helps us keep the focus where it belongs: on your care.