Great Lakes Vital Health’s staff is committed to providing you with quality health care and fostering a relationship built on trust. We welcome you as a patient and look forward to getting to know you. The purpose of this patient handbook is to answer commonly asked questions about our office policies and to outline some important details. Please read and electronically sign the bottom of this handbook before your first appointment: Download

When you register on-line, you will be prompted to complete a comprehensive set of healthcare questionnaires and to review and sign the practice forms and consents. When these are completed Dr Troiano will contact you to discuss what tests are to be ordered before your initial visit. When your test results are back you will be scheduled for your initial for 1 hour and 30 minute consultation where your individualized healthcare plan will be developed.

Follow-up visits are typically scheduled for 30-60 minutes, the frequency of which will be determined by the current issues.  Any forms required but not yet completed will need to be completed in the office prior to being seen and may shorten your time with the doctor, so please arrive accordingly. You will be sent appointment reminders, using the option you chose during your on-line registration (e-mail or SMS text) however; it is your responsibility to remember your scheduled appointment date and time. We cannot guarantee the messages we send will arrive due to invalid e-mail addresses, e-mail server issues, spam filters, or service interruptions.

The Health Maintenance Access Program will include quarterly visits to monitor progress and address new issues as they arise. In addition it will include message/email and telephone support.

  • If you need to cancel an initial appointment please provide us notice at least 2 business days prior to your appointment, and at least 1 business day notice for follow-up appointments.
  • When an appointment is canceled or rescheduled without the required notice, there will be a $50 cancellation fee.
  • All cancellations or rescheduling requests must be made by phone or portal message to our office.
  • If you are running late, your appointment time may be shortened by that amount of time, although the cost of the appointment is based on the scheduled visit time.
  • If an event where Dr. Troiano is running late due to an unforeseen emergency, we will attempt to notify you. You will still receive his attention for the full allotted time, as soon as he is available. If it becomes necessary to reschedule your appointment, of course there is no charge to you and we will accommodate your new appointment request as we are able.

New Patient Comprehensive Assessment – $1450

Your initial comprehensive assessment includes:

  1. Your first short discussion with GLVH
  2. Registration and completion of your healthcare questionnaires
  3. Review of pertinent previous records
  4. Determination and ordering of initial testing,
  5. When your testing results are back your initial 90 minutes visit
  6. Development of your individualized healthcare plan


After your Comprehensive Assessment, continuation with GLVH is through a Health or Peptide Optimization Program

Health Optimization Program – $195 per month 

– Minimum of 6 months required

Health Optimization including Peptide management – 245 per month

 – Minimum of 6 months required

Continuing Optimization Programs Include:

  • All visits
  • Ongoing portal messaging and telephone support.
  • Lifestyle coaching
  • Unlimited protocol changes including lifestyle modifications, medicines, hormones, and supplements
  • If on Peptide Optimization Program includes ongoing evaluation including stacking and staggering modifications
  • Bioidentical hormone replacement
  • Review and incorporation of all ordered labs, procedures, and imaging
  • Review of external tests once every 6 months if needed

Not Included:

  • Cost of
    • Supplements
    • Labs
    • Drugs
    • Hormones
    • Peptides
    • Autophagy agents
    • Treatment devices i.e. PEMF units
  • Specialized procedures / treatments
    • IV therapies, nutrients, peptides
    • Shockwave therapy
    • Microvesicles and the latest in regenerative therapies



Great Lakes Vital Health (GLVH) does not participate in Medicare or Medicaid but GLVH will discount our fees if you are on Medicare or Medicaid and can use the help.

Discounted Fees if on Medicare:

New Patient Comprehensive Assessment – $1350


Health Optimization Program – $175 per month

– Minimum of 6 months required

Health Optimization including Peptide management – 205 per month

– Minimum of 6 months required


  • Blood Draw – $35
  • Our patients are our top priority, and we strive to address your health questions and concerns as they come up. The online patient portal allows you to send secure messages to Great Lakes Vital Health day or night, however: please understand that we only monitor these messages during normal business hours and we will respond as soon as possible.
  • If you have an emergency, please call 911 or go to the closest emergency room.
  • Our office hours are generally Monday – Thursday 11:00am – 4:00pm.
  • We are closed on holidays.
  • Our office phone number is (414) 446-5389.

Written communication between you and our office staff should be through our secure, HIPPA compliant, encrypted, patient portal messaging system.

  • Messages you send via the patient portal are incorporated in your permanent health record.
  • You should receive Internet e-mail notifying you of new messages in your account Inbox, these e-mails will not contain any personal health information.
  • Once a message is made part of your record, it will be accessible to current and future Great Lakes Vital Health staff members who are involved in your care.
  • Great Lakes Vital Health will make every effort to respond to to your request or question in a timely fashion.


  • Your unique on-line identification (username) and password is used to access your health information at Great Lakes Vital Health.
  • It is extremely important that you keep your on-line username and password to your account completely confidential. If at any time you feel that the confidentiality of your password has been compromised, you need to change it by going to the Reset Password link on the website.
  • I understand that Great Lakes Vital Health takes no responsibility for and disclaims any and all liability or consequential damages arising from a breach of health record confidentiality resulting from you sharing or losing your password.
  • GLVH does not participate in Medicare or Medicaid. Neither you nor GLVH may submit bills to Medicare or Medicaid.
  • GLVH does not contract with health insurance providers and does not bill commercial insurance carriers directly.
    • As a courtesy to you, Great Lakes Vital Health will provide a super-bill, with procedure and diagnosis codes for you to submit to your health insurance provider. Dr. Flip’s effective approach to functional medicine, optimal aging medicine, and healing of mind, body, and spirit falls outside of the insurance industry “standard of care” which seem to be designed to increase health insurance profits and limit their exposure. Many patients do receive health insurance reimbursement for some of their treatment.
  • GLVH will tailor labs, other tests and prescriptions to help you maximize insurance benefits.
  • If Great Lakes Vital Health staff is required to cooperate with your insurance company or your insurance company requires part of your patient record, the will be a $50 handling fee.
  • Your lab and test results will be available to you via your patient portal after they have been reviewed.
  • GLVH will fax chart notes or lab results to another physician. There may be a fee involved.

I understand that there may be treatments recommended and performed by Dr. Troiano and I will receive a specific informed consent prior to a procedure.

Review patient rights and processes at the U.S. Department of Health and Human Services.

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