New Patient FAQs



Optimal Health Spectrums Practice Information

Frequently Asked New Patient Questions:

Office Hours:

Monday - 9:00a - 5:00p (lunch from 12:00p - 1:30p)

Tuesday- 9:00a - 5:00p (lunch from 12:00p - 1:30p)

Wednesday- 9:00a - 5:00p (lunch from 12:00p - 2:00p)

Thursday- 9:00a - 5:00p (lunch from 12:00p - 1:30p)

Friday- 9:00a - 4:30p (lunch from 12:00p - 1:30p)

Saturday - CLOSED (MediSpa: once per month by appointment only)

Sunday - CLOSED

We are closed on all major holidays. We will send out email announcements about any special closings, change our phone greeting to announce the change, and post the information on our doors.


Since we are a wellness-oriented integrative medical clinic, we are not contracted with any insurance plans. Therefore, our services are paid for out of pocket at the time of each appointment. If you have a PPO as your insurance carrier or have an FSA account to use toward medical expenses; we can provide you with an itemized receipt that you can submit on your own to receive reimbursement for your services (office visits or in-office laboratory services only). PPO insurance plans may partially reimburse in-person appointments and lab tests, but phone appointments are usually not reimbursable. Medicare patients may not submit their bills to Medicare because we are not a Medicare provider.


Fees are based on time spent with the provider. The cost of the initial consultation varies between $400.00 – $1,300.00, depending on the practitioner you see and the time involved. Follow up appointment length/pricing can vary based on severity of the case - fees will be charged at the end of the visit so that we accurately adjust/charge based on time spent.


Payment is due at the time that services are rendered. Cash, check, and credit cards are accepted (Visa, HelpCard, MasterCard, Discover and Care Credit). Our office can also assist you with applying for the HelpCard or Care Credit – these are credit cards for medical expenses through third party companies and are accepted at multiple other medical facilities. Approval for these cards only takes a few minutes - you may use this method of payment immediately upon approval. There is a $25 charge for returned checks. A superbill that you can submit to your insurance company will be provided at each appointment. Nutritional supplements are generally not covered by regular insurance, but may be covered under certain medical savings account plans.

Cancellation Policy

All Patients are responsible for remembering and coming to their scheduled appointments on time, but we will give you a courtesy reminder in advance of your appointment. Your scheduled appointment means that no one else can be seen at that time, so if you know that you cannot make it, please let us know 48 business hours prior to your appointment.

New Patients:

New patients will be asked for a credit card deposit of 50% of the appointment fee when scheduling to hold the spot. That deposit will then be applied to your appointment fee at your check-out. If you no show, cancel, or reschedule less than 2-days (48 business hours) prior to your new patient appointment, you will forfeit your deposit as a cancellation fee.

New IV Patients:

New IV Nutrient patients are required to make a $50 deposit to hold their first appointment. This deposit will then be applied to the cost of your first IV when you get it. If you are not cleared for the treatment or decide against any treatment, the deposit will be used for your consultation with our practitioner.

If you no show, cancel, or reschedule a Laboratory IV appointment less than 2-days (48 business hours) before the appointment, you will forfeit your deposit as a cancellation fee.

New MediSpa Patients:

New MediSpa patients are required to make a $100 deposit to hold their first appointment. This deposit will then be applied to the cost of your first MediSpa treatment when you get it. If you are not cleared for the treatment or decide against any treatment, the deposit will be used for your consultation with our practitioner.

If you no show, cancel, or reschedule a MediSpa appointment less than 2-days (48 business hours) before the appointment, you will forfeit your deposit as a cancellation fee.

In-House Lab Fees (sometimes covered by insurance):

Our lab facility is comfortable and inviting, and we offer specialized, personalized lab services. Our staff are experts in humanely performing difficult adult and pediatric venipunctures, have extensive experience with children of special needs, and a detailed understanding of accurately handling complex specimen processing. When blood is drawn and processed in-house for shipping, the cost is based on the complexity of the blood draw and the subsequent specimen processing time. The blood draw and processing fees are $60 per kit, number of kits are specific to each patient. The cost for the laboratory to actually perform the ordered tests on the lab specimen is in addition to these processing fees - the lab staff will provide you with an individualized folder including all the tests ordered, with a breakdown of cost for tests that insurance does not cover. Some tests, such as stool and saliva tests, are kits that you will take home and perform at home and mail directly to the lab to process. If you have recent lab results (within the last 3 months), the practitioner will be more than happy to review them to see if she can make a recommendation based on the results. Blood draws and I.V.’s are performed by appointment only, so that there is minimal wait time for our patients.

Appointment Frequency:

All patients must be seen in-person at a minimum of once per year, to continue to receive treatments of any kind at our office, including supplement or prescription refills, or ordering any tests. Depending on the health situation of the patient, more frequent appointments may be required in order to continue to receive treatments, for safety.

Parental Responsibility:

Parents are responsible for their children’s safety, behavior, and whereabouts at all times while in the clinic. Clinic staff is unable to monitor or supervise children during appointments. In situations of separation or divorce, additional treatment consents may apply for the non-custodial parent, and both parents may be required to attend appointments, either in person or over the phone.

How to prepare for your First Appointment:

After you have read the relevant sections of our website that pertain to your health issues, and have read “What is Integrative Medicine”, this document, please click on the “Become a New Patient” button to send us your information and request an appointment. After we receive your appointment request, within 2 business days we will contact you to set up your new patient appointment, answer any additional questions, and collect 50% refundable deposit to hold the appointment. We will also send you an invitation by email to sign up for our electronic medical records system, ChARM, so that you can fill out your new patient medical history intake forms online.

Fill out all the relevant forms in your ChARM portal no later than 24 hours prior to your first appointment. This is extremely important and may result in canceling your appointment, and forfeiting your deposit if this step is not followed. The forms will be sent to you at the time of scheduling your appointment. Also, upload any recent (last 6 months) labs and relevant medical history notes and a complete list of every medication and supplement you are taking (including doses in milligrams) into your ChARM portal. It is imperative that your provider is able to review your ChARM intake forms prior to your visit.


Important Information:

Appointment Times:

We offer appointments in many different time increments to meet your needs. We will estimate the amount of time needed. If the appointment runs longer than the scheduled time, we will charge for the additional time, since that is impinging on someone else’s appointment time. Please arrive a few minutes early for your appointments for any additional paperwork. We know that your time is valuable, and we appreciate your efforts to come to your appointments on time to help us stay on schedule, and likewise, we do our best to stay on schedule whenever possible while still providing good care to every patient.

Follow-Up Appointments:

At your follow-up appointments (in person or over the phone) you will receive a copy of your lab results. At that time we will carefully review your results with you and explain to you what they mean. All treatment decisions based on your lab results and current symptoms will be made at these appointments. Please do not request your lab results in advance of the appointment, as experience has shown us that this often generates anxiety and questions to our staff that need to be addressed at the appointment. There must be at least one inperson appointment per year to remain an active patient.


We strive for a toxin-free office for the health of our patients and staff, and request that you refrain from wearing perfume or any other scented products (including deodorants and lotions) when you come for your appointments.

Medication/Supplement list to bring to each appointment:

You should keep an updated medication and supplement list and bring it to every appointment, with doses listed in milligrams. We will provide a form for you to fill out. Doing this is an essential double check at each appointment to make sure that you are taking everything correctly.

Prescription Refills Between Appointments:

Please allow 48 business hours for all prescription refills.

Paperwork Requiring the Doctor’s Input:

For paperwork including writing letters, reports or filling out forms, the average cost is $15-$30, depending on time. Complex composition of letters will be more. Please fill out everything you can on a form before submitting to us. If you are requesting a special letter from the doctor, we request that you write a rough draft of the letter that you need. We will edit the letter, sign it, and return it to you for less cost.

Phone Calls/Messages:

Please call the main number to speak to our staff about setting up or changing an appointment. Staff can only answer administrative questions and cannot give medical advice or interpret lab tests. Established patients are welcome to securely message the office with brief, simple questions in ChARM between appointments. If a patient is having many issues or questions, it may require an appointment to review them and modify the treatment plan accordingly. Sensitive or personal questions should be answered in person at an appointment.

Patient/Staff Behavior:

We do not tolerate any form of abusive behavior in this office. If a patient is physically or verbally abusive to a staff member, they will be excused from our practice. Likewise, our staff must treat patients with respect at all times. If you have a problem with anything in our office, please calmly let us know and we will do our best to resolve it. Patient satisfaction is a high priority to us.

After-Hours Emergencies:

To contact Dr. Mielke or our Nurse Practitioner on an emergency basis only after regular business hours, call the main number and follow the prompts from the recorded phone system to page your practitioner. This is not to be used for prescription refills or other nonurgent issues that can wait until the next business day.


All information will be kept confidential, except where required by law. If needed, with your written permission, we will communicate with your primary care doctor or other providers about your treatment here.


Please understand that the wellness-oriented treatment that you may receive at this clinic does not replace your primary care doctor, and you will need to continue seeing your primary care doctor while in treatment here. For a true medical emergency call 911, go to the nearest emergency room, or contact your primary care physician.


How much does an office visit cost? What about testing and other costs?  

Please call the office for a discussion of fees for office visits and testing.  Costs for getting started with treatment are greater than maintenance treatment. Usually, some of the cost of office visits and testing is covered by the patient’s insurance plan. There is also usually some expense for nutritional supplements, which are necessary to correct nutritional deficiencies, and are the foundation for more advanced treatments. We do offer financial plans through the Helpcard and can spread out the costs of treatment when needed. We always try to work within your means.

Do you accept insurance? 

Our providers are considered out-of-network; all services are paid for at the time of receiving. However, many PPO plans will reimburse patients a percentage of their office visits, and will cover some of the tests that we order. We will provide you with an itemized billing statement that you can submit to your insurance company for reimbursement. Kaiser and HMO’s will not cover our services.

Some appointments can be done over the phone, but insurance usually does not reimburse for phone appointments. Please check with your insurance company prior to your appointment to get an understanding of your out-of-network coverage.

Are there any available sources of financial assistance?

Yes. The HELPcard® is a revolving line of credit you can obtain to purchase products and services from thousands of participating merchants and providers. Because we examine many levels of consumer credit, we can offer you a fresh source of financing beyond conventional lending.

The HELPcard® offers: Small, affordable payments, designed to fit any budget, Promotional terms available, Instant Approvals – no waiting to start your purchase, Experienced and friendly Customer Service Representatives to answer your questions, Automatic payment draft available, and On-line bill payment available.

We also accept CareCredit. You can use CareCredit to pay for out-of-pocket expenses not covered by medical insurance, and special financing options are available that you may not be able to get with other cards.

Pay for health, and wellness care at over 200,000 enrolled providers across the nation. Once you've applied, you can use it again and again at any location that accepts CareCredit. 

With shorter term financing options of 6, 12, 18 or 24 months no interest is charged on purchases of $200 or more when you make the minimum monthly payments and pay the full amount due by the end of the promotional period. If you do not, interest is charged from the original purchase date.*

*Subject to credit approval.

How long are the appointments? 

The initial intake appointment is usually an hour long, but can be adjusted depending on individual need. In addition, you will usually be at the clinic for at least another hour beyond that time to allow for the blood draw and the checkout meeting.

The first follow-up appointment is roughly one month later and is also scheduled for an hour. Again, we can adjust the time depending on the number of lab tests to review. After the first two, most appointments are half an hour or one hour in length, depending on the needs of the child. We also offer 15-minute appointments for quick questions in between regular appointments.

How often will we need to be seen? 

After the first two lengthy appointments, most patients need appointments approximately every two – three months. After they are stabilized, we may only need to see them once or twice a year.

How can I get in touch with the clinic between appointments if I have a question? 

For scheduling or supplement ordering information, you may call the office and speak with a staff member. You can also email us with quick questions.

Since emails are not confidential, the email release form must be signed before email communication is allowed. Simple questions that take less than 5 minutes to answer and do not involve chart or lab review are offered without charge. You can also schedule a 15 – 30 minute phone or in-person appointment to discuss any questions that you may have.

What do we need to bring to our appointments? 

For the first two appointments, please bring a note pad and pen to take notes, and if possible bring an audio recorder as well. There is a lot of information given at our appointments, and you will need to be able to write it down, and possibly even listen to it again if you choose. Audio recordings are for your own personal use only. 

For the first appointment, also bring copies of relevant medical tests and reports (no more than 20 – 25 documents), and a current supplement and medication list (if your child is already taking these). Please have the name of the supplement or medication, dose in milligrams, and the number of pills taken per day listed. For example: Zinc, 20 mg capsule, 1 capsule twice a day.  We also need a copy of your child’s immunization record and a copy of the insurance card.

Because this is such a long appointment, it is ok to bring light snacks (no chips or crackers) and favorite toys to the initial one hour appointment, so that your child is more comfortable. Be sure to reference the 
New Patient Checklist  on the website and in your new patient packet for a complete list of things to do before your appointment. 

In general, it is recommended not to bring the child to the second one-hour appointment unless the child is older and able to participate, because we will be reviewing extensive lab test results at that time.

What kinds of tests will you do? 

We order blood, urine, stool, and often hair tests.

We draw blood tests here at our office, but some of those tests can be done at a LabCorp or Quest location near your home. The urine, stool, and hair samples will be collected by you at home, and packaged and shipped directly to the laboratories in specially designed test kits. Just follow the instructions in the test kit box.

My child hates blood draws. Will this be a problem at your clinic? 

We pride ourselves on creating a comfortable and gentle atmosphere for laboratory blood draws. Our team is expertly trained in working with children on the spectrum and we will do our best to make sure the experience is a good one. We need to draw blood to evaluate many different systems in the body to find evidence of imbalances, and to determine what medical issues are priorities for your child. Everyone is different, and we customize our treatment plan to your child’s test results. Some of the testing is repeated later to make sure our treatments are working and to see if changes need to be made.

If we’ve done tests someplace else, can we use them? 

f the results are more than 3-4 months old, some of them may have to be repeated. Please send copies of any pertinent medical testing done in the past with your new patient questionnaire, the practitioner will review them prior to your appointment along with your medical information.

Will I get copies of all the test results? 

Yes. You will get copies of all of your test results at your follow-up appointments. If you would like a copy of your lab results before your follow up appointment, we can mail or fax them to you at no charge; a small fee will apply for lab results requested by email.

Please keep in mind that even if you receive your results prior to the appointment, a consultation is still required to review lab results and develop treatment recommendations.

How long does it take to get the test results? 

This depends partly on how fast the tests are collected and sent out.

Most test results come back between seven to ten business days of being shipped, depending on the test.

Connect with us!


Optimal Health Spectrums
4463 Stoneridge Drive
Pleasanton, CA 94588
Phone: 925-846-8000
Fax: 925-846-6323
Office Hours

Get in touch