Patient questions

Book a Consult with Liliana. Your initial consultation is separate from membership, and current consultation pricing is listed on the Pricing page. You can also use Find My Protocol to explore care paths and memberships in five questions before booking.

Have questions before booking? A free 15-minute discovery call can help you understand our programs and decide whether Viva is a good fit. Discovery calls are informational. Medical review, labs, and recommendations happen at your initial consultation.

Yes. I'm licensed in Texas, Colorado, and Iowa, and registered to provide telehealth in Florida. I'm accepting new patients in all four states. The booking page shows current appointment availability.

Texas, Colorado, Florida, and Iowa. I'm licensed in Texas, Colorado, and Iowa, and registered to provide telehealth in Florida. Viva is a one-hundred-percent telehealth practice, so visits happen by secure video wherever you are physically located in one of those states at the time of the appointment.

Labs are ordered during your initial consultation after a review of your medical history and goals. You may provide recent lab results for your provider to review, and additional testing will be recommended when needed.

Yes. You may provide recent lab results for your provider to review. If something important is missing or out of date, additional testing will be recommended.

Members message their provider directly through the secure patient portal, with prompt responses. Ongoing support, follow-ups, and adjustments are part of your membership. The portal is not for emergencies; call 911 in an emergency.

Every active membership includes one complimentary acute/sick visit per month for an appropriate minor illness that can be handled by telehealth. Medication or testing prescribed during that visit may cost extra. It is not for emergencies or for concerns that need an in-person exam; call 911 in an emergency.

Yes. Liliana evaluates perimenopause and menopause concerns including hot flashes, sleep disruption, concentration, mood, and weight changes without assuming they all have one cause. Treatment is individualized after clinical review and may include prescription or non-prescription options when appropriate. See women’s hormone care for more.

Yes, for appropriately evaluated women. Testosterone plays a role in women's health as well as men's. Its strongest clinical evidence is for improving sexual desire and function in appropriately selected women, particularly after menopause. Research on other outcomes is more limited, and benefits demonstrated in men cannot automatically be assumed in women. Evaluation considers your symptoms, health history, goals, and monitoring needs. Women are prescribed a small fraction of a typical male dose, with labs to keep levels in the normal female range. No testosterone product is FDA-approved for women in the US, so treatment is off-label.

Estradiol and progesterone can be prescribed through your retail pharmacy when appropriate. Medication costs are separate, and insurance may help cover eligible prescriptions. Compounded preparations, when prescribed, are available at an additional cost.

Yes. You can book a symptom and quality-of-life evaluation, with decisions made case by case alongside your oncology team. Systemic menopausal hormone therapy is generally not recommended after breast cancer. Nonhormonal options are considered first for vaginal and urinary symptoms; selected patients may consider low-dose vaginal estrogen after a shared risk-benefit discussion. This is different from systemic hormone therapy. Anyone taking an aromatase inhibitor needs shared decision-making with their oncologist.

Yes. Peptide management is included with all active Viva memberships. The Peptide & Therapy Guide explains individual therapies by topic, including evidence, approval status, and availability. Liliana reviews whether any therapy is appropriate for you at a clinical visit. Compounded drugs are not FDA-approved.

When a compounded medication is prescribed, the prescription is sent to a 503A compounding pharmacy for an individually identified patient. Compounded medications are not FDA-approved finished products. Ask Liliana to identify the dispensing pharmacy and explain product status, alternatives, and current availability before you decide.

No. FDA-approved brand medications and compounded medications are different products. Compounded drugs are not FDA-approved, and FDA does not review them for safety, effectiveness, or quality before they are dispensed. Whether any medication is available and appropriate depends on current law, supply, and an individual clinical evaluation. Liliana reviews the options, limitations, and costs with you before anything is prescribed.

Yes. Hormone management requires an additional membership if you're enrolled in a metabolic program. Peptide management is included with all active memberships, with peptide therapy costs separate.

Peptide management is included with all active Viva memberships. When prescribed, compounded peptide medications are dispensed by licensed 503A compounding pharmacies. Peptide therapies typically cost an additional $199 to $349 per month, depending on dose, pharmacy, and whether the formulation contains a single compound or a combination. Therapy costs are separate from membership.

Viva Concierge Access includes direct provider access, lab review, dosing guidance, peptide management, and one complimentary acute/sick visit per month for an appropriate minor illness. Prior authorization support is included; appeals after a second insurance denial are $50 per medication. Medication, labs, and pharmacy costs are separate.

TRT All-Inclusive is $199 per month and is available to appropriately evaluated men and women. It includes compounded testosterone at a provider-approved dose when prescribed, supplies, home delivery, ongoing management, and two provider-selected lab panels within 12 months. Additional labs and separately prescribed medications cost extra. Compounded medications are not FDA-approved. Membership renews monthly. Cancel through the booking portal at least seven days before your next billing date. If a multi-month medication supply was already dispensed, the unpaid balance for that supply is due when you cancel. Sexual health involves more than testosterone. When appropriate, we also evaluate erectile dysfunction and discuss other prescription treatment options.

Memberships are not billed to insurance. I accept FSA and HSA cards for membership fees. For labs and non-compounded medications outside the membership, insurance can be applied. Many patients use Viva Concierge Access specifically to keep their existing insurance for labs and prescriptions.

Yes. Submit a cancellation request through the booking portal at least seven days before your next billing date. On a medication membership, if we have already dispensed a multi-month supply, you remain responsible for the unpaid remainder of that supply. For example, if you receive a three-month supply and cancel after one month, the outstanding balance for the remaining supply is due when your membership ends. Concierge membership payments are non-refundable, and medication and labs on that plan are separate.

No. Viva replies to the non-clinical request you submit. Occasional practice updates and new educational articles are sent only when you select the separate optional email checkbox. Every marketing email includes an unsubscribe option.

The care-path guide runs in your browser and does not send your answers to Viva. If you request a call or text, only your name, phone number, and contact preference are sent through the non-clinical contact pipeline; your care-path answers are not. Please do not submit symptoms, lab results, diagnoses, medication details, or other clinical information through this website, a text, or regular email. Texts are not for health details. Use the patient portal for clinical questions. Once you become a patient, clinical communication moves into the patient portal. This website and regular email are not for health information.