Intake Form

Find Out if Transcend Is Right for You

Complete the short intake form to determine whether you qualify for Transcend’s personalized performance and wellness program.

As part of this process, an eligible participant will be invited to receive a Transcend Transformation Complimentary Upgrade, an enhanced program with an estimated value of approximately $20,000, based on the standard retail price of included services.

If you qualify and are selected, Transcend will provide its full suite of concierge medical and performance services, including:
- Comprehensive biomarker blood analysis
- Physician-guided treatment options such as HRT/TRT and peptide protocols when clinically appropriate
- Research-backed supplement protocols
- Nutritional counseling and personalized training guidance
- Participants will be selected from eligible Starter Package customers who complete the intake and medical prequalification process
Medical services and treatment eligibility are determined by a licensed clinician after review of your medical history and laboratory results.

Start your intake to determine your eligibility.
Lead Source
Wellness Specialist
Weight LossFitness & PerformanceHormone Replacement TherapyHealth & WellnessCognitive FunctionSleep SupportSexual HealthHair LossClinical TrialsOther
1. Excellent – High protein, low carbohydrates, minimal processed foods2. Good – Mostly whole foods with occasional processed foods3. Average – Mix of healthy foods and processed foods4. Not great – Frequent processed foods and inconsistent nutrition habits5. Terrible – Processed foods / fast food most days
1. Excellent – Resistance/weight training 4–5 days per week with daily cardio or activity2. Good – Resistance training 2–3 days per week and cardio most days3. Average – Exercise 1–2 days per week or occasional activity4. Not great – Rarely exercise or only light activity5. Do not exercise
Pricing
- HRT/TRT medical consult: $199 (required for all orders except supplements and counseling)
- Comprehensive blood work: $199 (required for HRT/TRT or recent blood work of your own)
- Treatments/Prescriptions: Varies depending on qualification
- Nutritional counseling: $125-$145 per session, depending on volume
- Supplements: Pricing available on our website
Your Information
Let’s start with your full legal name:*

First nameMiddle nameLast name
What’s your date of birth?*

MonthDayYear
Date
What is your phone number*
Please enter a valid phone number.Format: (000) 000-0000.
Email address*
example@example.com
What is your preferred method of contact?*
MaleFemale
Where will we send your treatments if you qualify?*

Street address

Street address line 2

CityState

Zip code
Legal Stuff (Quick but important)

I have read and agree to the Telehealth Informed Consent, Terms and Conditions, Medical Groups Notice of Privacy, Transcend Privacy Policy and Consumer Health Data Privacy Policy which are all available on Transcend Legal. I agree to receive text messages and/or e-mails from Transcend regarding my account, services and marketing promotions. Message and data rates may apply. Message frequency varies.
I agree
Please verify that you are human*
Should be Empty:

Find Out if Transcend Is Right for You

Pricing

Your Information

Legal Stuff (Quick but important)