Good Questions, Straight Answers.

Yes. Dr. Rachel Gougian is designated by USCIS to perform the immigration medical exam and complete Form I-693, and she has completed thousands of them. You can verify her designation yourself in the USCIS Find a Civil Surgeon tool before you book.

Plan on about an hour in the office. If your vaccine records are complete and no follow-up testing is needed, the I-693 is often finished within a few days of your visit. If we are waiting on a blood test result or a vaccine dose, it takes a little longer, and we tell you the expected date before you leave. The completed form goes into a sealed envelope for USCIS; you also receive a copy for your records.

Not if we can document them. Bring any vaccination records you have, in any language. When records are missing, immunity testing (a blood test, sometimes called a titer) can show that you are already protected, so you only get the vaccines you actually need. No guesswork, and nobody treated like a pincushion.

A government-issued photo ID such as a passport or driver’s license, your vaccination records, and any medical records about chronic conditions or past tuberculosis testing or treatment. If your attorney gave you instructions, bring those too. If something is missing, call ahead and we will tell you what actually matters.

Usually within the week, and often sooner; book online to see live availability. The exam fee is quoted before you book, and blood tests or vaccines are added only if you need them, so there are no surprise costs. Immigration exam pricing→

Wegovy and Ozempic are the same medication, semaglutide, approved under two names: Wegovy for weight loss and Ozempic for type 2 diabetes. Mounjaro and Zepbound are both tirzepatide, with the same split. All four are GLP-1 medications taken as a weekly injection. Which one fits you depends on your health history, your insurance, and your goals, which is exactly what Dr. Gougian, a Diplomate of the American Board of Obesity Medicine, works through with you at the first visit.

You don’t need to prove anything to have the conversation. People come to us at a wide range of weights and health situations. Some medications have FDA guidelines tied to BMI and related conditions, and insurance plans have their own rules, but there are almost always options. If a GLP-1 isn’t the right fit, older and less expensive medications like phentermine, Qsymia, Contrave, or metformin may be. No judgment, ever.

Because willpower was never the missing piece. Obesity is a chronic medical condition with biology behind it, and treating it medically, with a physician trained in obesity medicine, is different from another diet. We combine medication when it is appropriate with realistic changes to eating, sleep, and daily movement, and we follow up regularly so adjustments happen before you get discouraged.

Those are subscription telehealth services. Here you see the same doctor, in person, in your neighborhood, with no subscription. The visit is $200 to establish care and $150 for follow-ups, paid only when you are seen, and many insurance plans cover the visit. The medication is a separate cost, and we help with prior authorization so your plan covers it whenever possible.

We talk: about your history, what you have tried, the medications you take, and what you want to change. We order labs when they are needed, check your insurance coverage for weight loss medication, and you leave with a plan you understand, including what the medication will cost you.

Yes. We accept Medicare and Maryland Medicaid, along with United Healthcare, Aetna, Cigna, Blue Cross, CareFirst, and Anthem. Self-pay is welcome too.

$200 to establish care and $150 for follow-up visits. Immigration exams and aesthetic treatments have their own flat prices, quoted before you book. We always tell you the cost before you are seen.

Many plans require prior authorization (PA) before they will cover Wegovy, Zepbound, or similar medications. It feels complicated because it is, so we do it for you: our office submits the paperwork, answers the insurer’s questions, and keeps you posted. There is no separate charge for PA help; it is part of your care here. How prior authorization works→

It happens, and it is not the end of the road. We tell you why it was denied, appeal when there is a case for it, and talk through alternatives: a different medication your plan does cover, manufacturer savings programs, or paying out of pocket with a clear price. Your visit is never wasted, because the plan we make is not tied to one medication.

Both are botulinum toxin type A injections that soften lines from frowning, squinting, and raising your brows. They work the same way and last about three to four months. Jeuveau is newer and sometimes a little less expensive; Botox has the longer track record. Dr. Gougian uses these treatments herself and will tell you honestly which makes sense for you.

Lumecca is intense pulsed light. It targets sun spots, uneven redness, and broken capillaries to even out skin tone. A session takes about 20 to 30 minutes and feels like a quick warm snap against the skin. Most people see results after one or two sessions. Expect spots to darken for a few days before they flake away.

Yes. Tretinoin is a prescription retinoid and the most studied skincare ingredient for fine lines, acne scarring, and uneven texture. It is prescribed here like any other medication, with a plan for starting slowly so your skin adjusts.

Botox and Jeuveau are priced per unit; IPL is priced per session. You get the exact price before anything is scheduled, and there is no membership or package requirement. Aesthetic treatments are not covered by insurance.

Yes. That is the whole idea. You establish care with one physician and see that physician at every visit. As the practice grows to include another doctor or two, your doctor will still be your doctor.

Schedule online any time to see live availability, or call 301-200-0960 during office hours. New patients don’t need a referral to establish care. For non-urgent questions, email office@pandoramedicine.com.

Time. First visits are booked long enough to hear your history and your concerns, review your medications, and agree on what happens next. Bring your ID, insurance card, a list of medications, and any recent records or lab results.

Yes. Dr. Gougian sees patients in English and Spanish, including immigration medical exams. Examen médico de inmigración en español→

We are closed on Major Holidays. Not open every Saturday