Rak Your Life Interest Form and Preferences
Thank you for your interest in Rak Your Life and working with Dr. Rak. You can learn about Rak Your Life membership options on
If you are interested but need more info, please consider attending one of the upcoming worshops [
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Please enter your first and last name
Please enter your phone number with area code
Please select the option that best applies:
I would like to join Rak Your Life as a Tribe member (weekly group health coaching calls)
I would like to join Rak Your Life as a Solo member (medical appointments with Dr. Rak, State Availability for Medical Visits: CA, TX, FL, NY, UT, CO, IN, PA, TN
I would like to join Rak Your Life as a Total member (weekly group health coaching calls+ medical appointment, State Availability for Medical Visits: CA, TX, FL, NY, UT, CO, IN, PA, TN)
Please don't add me to the waitlist at this time. I am interested but need more info.
If you are interested in joining a RYL Tribe, indicate which of the following weekly times would work for you.
Mondays at 430pm PST/730pm EST (Tribe already in progress)
Wednesdays at 1pm PST/4pm EST (starting soon!)
Would you like to be added to Dr. Rak's email newsletter, Rak On?
Yes, please add me to the mailing list
I am not interested at this time
Please let us know any
questions, comments, or specific interests you may have.
Send me a copy of my responses.
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