Apply for a Health Optimization Group with Trevor
Please use this form to apply for this group. The information you provide here will be held in confidence. After you submit your application you will receive an email from us with your answers.
Email address *
First Name *
Your answer
Last Name *
Your answer
Phone no. *
Include the country code if outside the US
Your answer
City and Country of Residence *
Your answer
Which day do you prefer to meet? *
All sessions begin at 5:00pm Eastern / 2:00pm Pacific.
Which day is your second choice? *
All sessions begin at 5:00pm Eastern / 2:00pm Pacific.
Would you prefer a lower price and a larger group or a smaller group with a higher price? *
Please describe your illness or condition and its impact in your life
Your answer
Have you previously worked with Trevor? *
Please provide details about your individual sessions or groups with Trevor.
Your answer
Is there any other information you would like to share with us?
Your answer
A copy of your responses will be emailed to the address you provided.
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