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Private Client Application
Once the application is submitted and upon availability + acceptance, we will contact you to schedule a 15min clarity call. This call is *not* for personal medical advice, nor for sales. The purpose of the call is to clarify any outstanding questions you may have. By submitting your application, you agree to the terms of this call.
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Email
*
Your email
First Name
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Your answer
Last Name
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Your answer
Top 3-5 health concerns
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Your answer
MAIN *specific* goal you want to accomplish over next 6 months (ie: Reduce anxiety to 2/10 severity, with it only occurring 1-2x per month for <2 hours).
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Your answer
Briefly describe what you've tried so far to relieve or address your concerns (food, lifestyle, home remedies, counseling techniques, supplements, previous practitioners or programs). Please indicate what has brought the most relief.
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Your answer
Are you currently under the care of a local primary care provider or under a practitioner's care for a specific health concern?
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Yes
No
Are you currently ready to invest in addressing the root causes + taking charge of your health?
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Yes
No
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