Request an Appointment I Stroke Clinic - Vascular Neurology in Minnesota

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Request a Stroke Clinic Appointment.

Clinic Address:

Minneapolis Clinic of Neurology

Southdale Place

3400 W. 66th Street, Suite 150

Edina, MN 55435

Please fill out the information below and one of my staff members will reach out to you to schedule an appointment.

Contact Form

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If you are interested in working with Dr. Zubkov online, please fill out the form below

Initial Evaluation Form

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You will be able to schedule your discovery call after filling out this short form

First Name

Last Name

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Phone/Mobile. Please select country code

Address

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Date of Birth

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Referred by:

What do you hope to achieve in your visit with me?

If you had a magic wand and could erase 3 problems related to your health, what would they be?

Have you made the decision to change? To do what it takes to reach your highest level of wellbeing?

List up to 5 things that you have been unable to do as a result of your present level of health and/or symptoms. Please be very specific.

Are there any other health goals you want to achieve? Please be very specific.

In order to get the result you desire, how willing are you to do the following: (5 stars being highest)

Significantly modify what and how you eat?

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Perform laboratory assessments that include collection of blood, urine, stool, and/or saliva?

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Take several nutritional supplements each day?

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Keep a detailed record of everything you eat each day?

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Modify your lifestyle (e.g. work demands, sleep habits, environment)?

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Practice relaxation techniques daily?

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Engage in exercise 2 days a week ?

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Have periodic lab tests to assess your progress?

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How confident are you of your ability to organize and follow through on the above health related activities?

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If you are not confident of your ability, what aspects of yourself or your life lead you to question your capacity to fully engage in the above activities?

At the present time, how supportive do you think the people in your household will be to your implementing the above changes?

How much ongoing support and contact (e.g. telephone, email correspondence) from your professional staff would be helpful to you as you implement your personal health program? (5 being the need for more frequent contact)

You will be able to schedule your appointment by clicking below.

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