Gut Rehab Intensive Application Form
Thank you so much for trusting me with your health! By completing this application form, you will be added to the waitlist and contacted when a spot in Gut Rehab opens up. The next step in this process is for us to chat and determine wether the program is a good fit for you.
First and last name:
Where do you live? (city and country)
What are the main issues you're hoping Gut Rehab will help with? Let us know about anything you've been diagnosed with and/or discomfort you are experiencing currently.
What have you already tried to help with these concerns? Have you seen your doctor or another practitioner already?
Are you currently being treated for any medical issues? If so, please explain.
On a scale of 1-10, how committed are you to making nutrition and lifestyle changes as recommended? Even if it means giving up gluten or coffee?
Herbs and supplements will likely be a part of your plan and can cost up to several hundred dollars. We do not earn any income on supplement sales and do our best to secure you the lowest costs available, but are you prepared to pay for these supports in order to follow your protocol?
Is there anything you are not willing to do or that would stand in the way of you getting amazing results?
Are you ready to invest $2398 into your health today? (A payment plan is available.)
Absolutely - sign me up!
I'm not ready
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This form was created inside of Ashley Sauvé Health.