How much time do you spend on initial consultations?

New patient visits with Kara Stiles, Nurse Practitioner (medicine) are around 45 minutes.

Dr. Blair (bodywork and movement medicine) offers 60 and 90 minute options for new patient visits.

Initial evaluations with Cameron Pellegrino, PMHNP (mental health & nervous system) are 60–90 minutes.

Do you take insurance?

Cameron (mental health) accepts many insurances.

Kara (medicine) and Emily (bodywork) are self pay per visit but can accept FSA/HSA cards and can provide superbills if requested.  This allows us to spend time with you during your visit. Another benefit is that we can usually get you on the schedule within a week or two!

Do you offer guidance on lifestyle changes?

We sure do! In fact, we strongly believe that empowering YOU to take control of your health is what good medicine is all about. Hydration, sleep, nutrition, quality movement, stress reduction - these are all key factors to feeling your best. We can help you make positive changes in your life!

Do you recommend non pharma options / supplements?

Yes. With our community networks we can guide you on multiple healing modalities from both Western medicine as well traditional therapies. This might include hormones, Western prescriptions, herbs, adaptogens, vitamins and supplements.  We do not sell supplements, nor do we profit from any that we recommend.

Do you offer nutritional counseling?

Yes, see the Medicine page for more information.

Do you require labs?

We do not have a lab in clinic but you have options! 

You can ask your in-network provider to request labs, you can bring in labs from the past year, or we can discuss what labs you might need and you can have those drawn for self-pay. 

Area labs like Qwest, LabCorp, etc. allow you to self select your own labs.  During your initial visit we can help you determine the labs that you need.

Cameron can also order laboratory testing when clinically indicated, particularly when evaluating mood, sleep, metabolic health, or contributing medical factors.

What is your training?

Please see the About Us page for detailed information on our education and training. We are always learning and striving to give you the most up-to-date (and down-to-earth) information possible!

Additional Mental Health & Nervous System FAQ with Cameron Pellegrino, PMHNP

These questions are some of the most common concerns women bring to me during perimenopause and menopause.

Hormonal transitions affect more than the body.

They affect the brain, mood, sleep, and nervous system.

Is it normal for my anxiety to get worse during perimenopause?

Yes.

Hormonal fluctuations — especially shifts in estrogen and progesterone — directly affect the brain and nervous system. Many women experience increased anxiety, irritability, or panic during perimenopause, even if they’ve never struggled before.

This is common. It is not a personal failure.

The goal is to stabilize the nervous system so symptoms feel manageable rather than overwhelming.

Why do I feel unlike myself lately?

Hormonal transitions affect sleep, cognition, mood regulation, and stress tolerance.

When sleep is fragmented and the nervous system is on high alert, it can feel like your personality has changed.

Often, we are not looking at a personality shift — we are looking at a dysregulated nervous system.

When regulation improves, clarity and steadiness often return.

Is brain fog related to menopause?

It can be.

Estrogen interacts with memory, focus, and executive function. During perimenopause, fluctuating levels can affect concentration and processing speed.

Brain fog can also be amplified by poor sleep, chronic stress, and anxiety.

Part of my role is helping sort out what is hormonal, what is stress-related, and what may need further evaluation.

Do you prescribe medication?

Yes, when appropriate.

Medication is not the only tool, and it is not always necessary.

If medication is considered, it is discussed thoughtfully, with full context, and tailored to your goals and medical history.

The goal is not numbing.

The goal is stability.

Can I work with you if I prefer non-medication options?

Absolutely.

Many women benefit from nervous system regulation strategies, sleep stabilization, stress reduction, and somatic tools without medication.

We explore options collaboratively.

When should I seek mental health support during menopause?

Consider support if you experience:

• anxiety that feels unmanageable

• persistent sleep disruption

• mood swings that affect daily life

• difficulty concentrating

• emotional overwhelm or loss of resilience

Early support often prevents symptoms from escalating.

Do I need to be in crisis to schedule with Cameron?

No.

Many women seek support when symptoms first begin interfering with sleep, mood, focus, or daily functioning. Early care often leads to better outcomes.

Will working with Cameron replace my therapist or primary care provider?

No.

Care is collaborative. Many patients continue working with therapists or primary care providers while receiving mental health and nervous system support.

How do hormones affect mental health?

Hormones influence neurotransmitters, sleep cycles, stress response, and emotional regulation.

During perimenopause, fluctuations can increase vulnerability to anxiety, mood changes, and cognitive shifts.

Support focuses on stabilizing the nervous system and improving resilience during this transition.

What if I feel overwhelmed and don’t know where to start?

That’s common.

The first step is assessment and clarity. Once we understand your specific pattern, we create a plan that feels manageable and realistic.

You don’t have to figure this out alone.