Free 20-Minute Discovery Session Request
Thank you for your interest in working with Deconstruct Health to get you on track to recovery!

In order for us to make the most out of your discovery visit, please answer the questions below and we will get back to you within 1-3 business days to schedule your appointment.
Email address *
Full Name *
Your answer
Age *
Your answer
Pronouns
ex. He/Him/His, She/Her/Hers, They/Them/Theirs, etc.
Your answer
Phone Number *
Write out phone number using only digits.( Ex. 3104444444)
Your answer
Which City, State are you located in? *
Your answer
How did you find out about us? *
Your answer
What service(s) are you interested in? *
Required
Discovery Visit Location Options *
Preferred Day(s) and Time(s) *
Required
Please provide a brief summary of the problem you are looking to discuss. *
Your answer
What have you tried to address this problem? How effective were the treatments/providers at addressing the problem in the short term? How effective were the treatments/providers at addressing the problem in the long term? *
Your answer
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