Advanced Wellness Program Agreement

Advanced Wellness Program Agreement

Fill out the form below to enroll or re-enroll in Dr. Grover's Concierge Advanced Wellness Program!
Overview of Benefits:
Assessments:
- Annual Physical Wellness Exam
- Evaluation of comprehensive blood work (unlimited)
- Genetic testing and counseling (if indicated or desired)
- Body fat analysis (unlimited)
- Specialized testing (stool, cardiac, allergy, urine, etc.
Recommendations:
• Dr. Grover provides in-depth health goals to help you achieve an optimal state of Mind, Body, and Lifestyle through a functional and integrative approach.

• Preventative health recommendations including Cardiovascular and Cancer screening

• Hormone balancing recommendations and adjustments if needed

• IV therapy and peptide recommendations

• Skin care evaluation and recommendations

• Regenerative medicine recommendations such as nutrition, supplements, or exosome therapy
Anti-Aging/Bio-Identical Hormone Therapy:
If desired by the patient, Dr. Grover will order, review, and make recommendations for optimizing sex hormones, thyroid, adrenal, and growth hormone as indicated.
Wellness & Nutrition Coaching:
Wellness coaching appointments can be made with our nurse, Julie. This is especially helpful if you would like help with nutrition, weight loss, muscle gain, cognitive optimization, or gut health optimization.
Communication:
·      Physician access via email 24/7

·      Accommodations whenever possible for same day or next business day appointments for urgent medical situations

·   Long appointments (if needed)

· 10 Annual Visits with Dr. Grover (Zoom, phone, or in-person visit options)

·   Email and phone support with our office
Financial Benefits:
- Highly discounted lab pricing
- 15% off Vivace
- Botox at $12/unit.
- 15% off ALL supplements
- 15% off ALL peptides and IV therapies
- (3) FREE Pulse Electromagnetic Frequency Therapy Sessions (PEMF)
- Additional family, spouse, sibling or significant other may receive a 10% discount on their membership fee

MEMBERSHIP FEES & PAYMENT OPTIONS
Members shall pay an annual membership fee to Fred Grover Jr. M.D. per the schedule selected below.

You will be contacted about renewing your membership before it expires.
PLEASE CHECK DESIRED FEE SCHEDULE*

4 QUARTERLY auto-charged payments1 ANNUAL payment12 MONTHLY auto-charged payments
OUR OFFICE STAFF WILL CALL YOU TO COLLECT YOUR CARD INFORMATION OVER THE PHONE. THIS CARD WILL BE KEPT ON FILE TO PROCESS ALL RECURRING PAYMENTS ASSOCIATED WITH YOUR MEMBERSHIP.

YOU CAN CHANGE THE CARD ON FILE AT ANY TIME.

EARLY TERMINATION
By checking "I agree", you understand that if you decide to terminate your annual contract before it expires, you will not be reimbursed or refunded any payments already made. If you decide to terminate your contract early, you are responsible for an early termination fee of $500. Dr. Grover will not be able to continue refills of medications beyond a 3-month grace period should this agreement be terminated.*

I agree
EMAIL OR ZOOM COMMUNICATIONS PRIVACY
By checking "I agree", you are aware that by wishing to communicate via email, phone, or Zoom with Dr. Grover, your personal health information may not be protected through a secure medium. Although Dr. Grover will take steps to keep your communications with his practice confidential and secure, the confidentiality of email communications cannot be assured or guaranteed.*

I agree
By signing below, you are consenting to any and all principles, agreements, and responsibilities stated above.*

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3400 E. Bayaud Ave, Suite 444 Denver, Co. 80209

Email: Revmdoffice@gmail.com

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Advanced Wellness Program Agreement

Overview of Benefits:

Assessments:

Recommendations:

Anti-Aging/Bio-Identical Hormone Therapy:

Wellness & Nutrition Coaching:

Communication:

Financial Benefits:

MEMBERSHIP FEES & PAYMENT OPTIONS

EARLY TERMINATION

EMAIL OR ZOOM COMMUNICATIONS PRIVACY