Level 1 Consultation

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Name
First Name
Last Name
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Email
example@example.com
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Phone Number
Please enter a valid phone number.
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What is your current issue you want help with?List all Current Health issues
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Do you have any pain?If answer is no skip to question # 6
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If so, how bad is it on a scale of 1-10?
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Is your pain constant or intermittent?
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Anything in particular that you feel may trigger the pain?
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What are your current health symptoms?
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Current weight?
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Height?
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Where do you live?
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What is your current eating habits?
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Favorite Foods?
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What time do you eat breakfast, lunch, and dinner, approximately?
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What brands do you like?
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Stores you like to shop at?
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What kind of water do you drink?
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Type a question
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Amount of water that you're drinking per day?
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Any restrictions on the amount of water you can drink? If answer is no skip to question #19
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If so, what are they?
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Current medications, if any?
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Are you currently taking any vitamins or supplements?If answer is no skip to question #22
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If so, which one's (name and brand please)?
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Any surgeries, day procedures, kemo, radiation, or keytruda?
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If so, what kind did you have and when?
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Do you smoke?If answer is yes skip to question #26
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Are you around smoke?
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When was the last time you went to the doctor?
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When was the last blood panel you did?
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If recent, within the last ninety days, may we have access to see it?
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Do you have a support team?If answer is no skip to question #31
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Is it so can they join us at your zoom meeting?
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Do you have any health goals?If so, what are they?
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Please select the best time to meet* This field is required.
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ORDER SUMMARY
Total costUSD
Level 1 - Advanced health consultation
$299 Time: 1:30- 2 hrs Zoom Follows up: 2 Detailed plan outlining their next thirty-day cleanse. A sample grocery list of what to Buy. 1 recipe on how to make a gluten-free, dairy-free meal. Our advanced health consultation offers a deep dive into your wellness journey. You’ll receive a 1.5 to 2-hour Zoom session where we assess your health needs in detail. Following the consultation, you'll get a customized 30-day cleanse plan tailored to your goals, a sample grocery list to guide your shopping, and a gluten-free, dairy-free recipe to jumpstart your new diet. Plus, with two follow-up sessions included, you'll have ongoing support to ensure you stay on track and achieve the best results for your health.
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Credit Card
First Name
Last Name
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Account Holder Name
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