Readiness Assessment

Readiness Assessment
Please complete a these questions that give us insight into your journey as well as your current goals and challenges.

If you previously filled this out, click here to skip the form and go directly to the online appointment scheduler.
First Name*
Date of Birth*
Sex at Birth*

MaleFemale
State you reside*
(we virtually serve all 50 states in the U.S. except NY, NJ and RI due to government restrictions on labs)
What is your main health complaint?*
When did this issue start?
How often does it bother you?
How does this affect your life or what does it prevent you from doing?
Anyone in your household or family dealing with similar issues?
Who or what would prevent you from completing a health rebuilding program?
Do you have a good support system? (friends, family, etc)
What are you willing to commit to? (Check all that apply)

Significantly modify what you eat and drinkModify your lifestylePractice relaxation techniquesDevelop Sleep habitsTrack your diet, rest, exercise and stressTake nutritional supplementsPursue spiritual growth
Plant based diets such as vegan/vegetarian are not our specialty.*

You understand that animal based foods and supplements will be suggested without plant based alternatives.
What would you reasonably expect to achieve while working with us for the next 3 months?
What excites you most about working with us?
How did you hear about us?
On a scale of 1 – 10 how important is it to solve your main health complaint?*

1 (not important)2345 (I can wait)678910 (ready today)
Our Signature VIP package is a 90 day deep dive into looking for and addressing root causes of loss of function. It is a proven process that focuses on digestion, sleep, exercise, stressors to the mind & body and spiritual wellness. This package is currently priced at $3000.

In addition are functional labs that are essential to identify hidden stressors. They start at $900 and are billed separately. Which lab panels are done and how many will depend on the issues you are battling. For some chronic issues this can easily get to $4,000+ but worth it to finally find out what is going on in you body.

Lastly, suggested supplements are used to support body function. They are optional but can greatly help. These can be purchased at the place of your choosing or on our webstore with a 20% discount.

Please note:
- Full details of this package are on our website on the Appointment page.
- Labs and supplements are not included in the package price.
- Our services are not covered by insurance. HSA and FSA might be possible based on your carrier but we don't guarantee it. We found it helps to have a doctors note stating holistic health services are medically necessary.
- Chronic conditions may need services for 6 months or longer depending on how long this has been an issue.
- Pricing may change at any time.
Check all that apply

I’m good with the time frame and financial investment if this is something I decide I want to do.I might need a payment plan!The Signature VIP package might be too much for me, but I’d still love to get guidance with a session or two.
Comments
Clicking submit will take you to our online appointment scheduler for a free Discovery Call where we share our process, answer questions and decide if we are to work together.

Thank you for considering us to help on your journey to wellness.
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