New Client Inquiry

Hello and thank you for considering the Life RESET Program for optimizing your health. Please take a moment for a deep breath and THANK YOUSELF for having made this decision to take that first big step to RESET your life!

Please know that we are experiencing a tremendous demand at this time and ask that you please FIRST fill out this form. You'll then receive a call from Steven. Together you can decide if our program/service is a good fit. Your submission will be placed in que and you will be called in the order received. Sometimes it may take a couple business days to get back with you due to the number of inquiries we get.

Thank you so much in advance for your patience. Of course we cannot make promises, but we feel pretty certain it will be worth the wait.

To your health,

Steven Dragon

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Country

Phone Number*

E-mail*

example@example.com

What is your top challenge that you would like help to overcome FIRST?*

What are your secondary concerns, if any?

Are you willing to do what's necessary to reclaim your health? (This may include, dietary modifications, lifestyle adjustments, emotional healing and environmental modifications)*

YesNo

Do you consider yourself coachable?*

YesNo

FINANCIALS

Fees

Steven Dragon

LifeRESET - Custom Packages Available

Holistic Health & Wellness - Level 1, 3-6 month package (~27 sessions) - $8,997

Human Potential / Trauma Integration - Only New Client (~2 Hr) - $597

Human Potential / Trauma Integration - Established Client (~1 Hr) - $397

Please know that, depending on your current level of health, you should expect to have anywhere between 2-5 follow up visits. The fees listed do not include nutritional supplements. The fees are for Steven's time.

INSURANCE

Steven does NOT bill insurance. If you have a Health Savings Account (HSA), we are setup to receive those paymets, but we do not bill conventional insurance. Coaching/personal development is a TAX write-off for entrepreneurs and small business owners so please enjoy this TAX deduction.

CANCELLATION POLICY

For New Clients, should you need to cancel and move your appointment, please know that we require a firm 48-hours so we may get another CLIENT moved into your time. If this is not provided, you will forfiet your deposit and ability to reschedule.

PLEASE NOTE: WE DO NOT ACCEPT FLIGHT DELAYS OR FLIGHT CANCELLATIONS AS AN EXCUSE TO MISS AN APPOINTMENT. WE STRONGLY ADVISE THAT YOU DO NOT BOOK ON DAY OF TRAVEL TO AVOID BEING CHARGED - for any appointments made.

REFUND POLICY

At the end of each session there is a check-in. If you do not feel the session was valuable, you may request a "re-do" or a refund for that session. To ensure you have the best esperience possible, communicate youu expectations at the beginning of a session as well as your resistance to getting what you desire.

We understand some people have to work around other schedules such as a job, school, childcare, travel, etc. However, please be advised that being "on call" or needing to be flexible and canceling your appointment, or not showing up, for any of the above is NOT a valid reason to not adhere to our cancellation policy. Therefore, if you have days that must be flexible with time, please DO NOT SCHEDULE on that day. THIS INCLUDES TRAVEL AND ANY POTENTIAL CANCELLATIONS OR DELAYS*

Yes, I am clear on the scheduling requirement and my commitment to the appointment I schedule.No, I am not able to commit to treatment at this time.

I am clear on the requirement noted above under FINANCIALS and I am able to commit to achieve optimal health.*

Yes, I am clear and able to commitNo, I am not able to commit at this time

Who else have you worked with?

Are you willing to do what's necessary to reclaim your health? (This may include, dietary modifications, lifestyle adjustments, emotional healing and environmental modifications)*

YesNo

How did you hear about Steven Dragon and the Life Reset?*

Online Video/StreamInternet SearchReferralOther

If a personal or professional referral, please share their name.

What's the best time(s) to reach you?

Any other brief question(s) or notes?

NOTE: If you checked NO to any of the above questions, your inquiry will likely be archieved. Please check back and resubmit a form when you are ready for change and are able to commit.

_____________________________________________________________

DISCLAIMER: Statements have not been evaluated by the Food and Drug Administration. The work provided, including nutritional and detoxification suggestions are not intended to diagnose, treat, cure, or prevent any disease.

Thank you for your information. We will be reaching out to you within 2 business days to discuss your needs and to see if this will be a good fit.