Ready to Start Your

Healing Journey?

Click below to answer some questions about your health so we can get to know you better! Our team looks forward to connecting with you!

Do you have a spouse/significant other? Are they supportive of your health journey? *

My spouse is actively involved in my health journey

My spouse supports me in my health journey as best as they can

My spouse is indifferent to decisions I make for my health

My spouse is not supportive of my health journey

I do not have a spouse

What are your main health concerns? How long have you been suffering from these issues? *

What is your current occupation? *

On a scale of 1-10, how important is it for you to resolve your health concerns? *

Do you currently follow a specific eating strategy? Select any options that apply to you *

While we wish that insurance would pay for what we do, unfortunately insurance does not cover services, specialty labs or supplements. To what level are you prepared to invest in your care? *

On a scale of 1-10, how willing are you to make the appropriate lifestyle changes that may be necessary in order for you to achieve your goals? *

What is your name? *

What is the best phone number to reach you? *

Our team will reach out to the number you provide above confirm the details of your application and book your health assessment.

And your email? *

Phone: 239.326.0256

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