The Wellness Workup Initiative Registration Form

The Wellness Workup

This offering is made possible through Well Wellness Naturopathic Care as a Community Service Initiative. https://wellwellnesshealth.com
The first week of each month, you can request labs that matter to you, whether you're searching for peace of mind, preparing to advocate for yourself, simply curious about where you stand with your labs, or starting your healing journey.

Dr. Brie believes that access to foundational health insight should be available to everyone. This is more than a test. It's your baseline for your testimony. This is an opportunity to gain insight into what's really going on inside your body without needing a referral or relying on insurance. When you know what's happening in your body, you can become aligned for complete wellbeing.

Your labs are yours to:

Keep for your own awareness
Review with your doctor
Or take the next step and work with me through

Registration Fee: $45
Access to over 7,000 labs (pay for labs at discounted rate)
Participant Information
Name

First NameLast Name
Phone Number
Email
example@example.com
Date of Birth

MonthDayYear
Date
Biological Sex
City,State you Reside in
How did you hear about The Wellness Workup Initiative? Please name the organization or provider who referred you.
Wellness Snapshot
What are your top 1-3 health concerns right now?
What symptoms are you currently experiencing? (Check all that apply)

Fatigue/Low EnergyBrain FogHair Thinning or LossDry, itchy, or Acne-Prone SkinBloating or Digestive IssuesAnxiety or DepressionPainful or Irregular PeriodsPMS or PMDD SymptomsSpotting Between CyclesMood Swings or IrritabilityChronic PainDifficulty Losing Weight or Gaining WeightLow LibidoOther
Have you had lab work done in the past 6-12 months

YesNoNot sure
Do you have Health Insurance and/or a Primary Care Provider?
What would you like to do with your lab results?

Keep them for my own awarenessesShare them with my doctorLearn more about working with Dr. Brie for a personalized wellness planLearn more about working with Dr. Brie for a custom botanical tincture
Would you like support in choosing which labs to order based on your symptoms?

Yes, please help me decideNo, I know what I want to test
Consent
This is a community service wellness service. Lab fees vary and are paid separately. The $45 registration covers access to over 7,000 labs + administrative + consult fee to order your tests. Do you acknowledge and accept this?

YesNot yet, I just want more information
Once your form is reviewed, you'll receive an email with instructions to: 1. Set up your Fullscript account (where your labs will be ordered), 2. Receive a call from Dr. Brie reviewing your registration form, 3. Receive your lab order, and Submit payment for labs + $45 Registration fee. If you'd like more clarity on which labs to oder, Dr. Brie can go over recommendations during your call with her. Do you acknowledge and accept this?

Yes
Any additional comments or information you would like to share?
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The Wellness Workup

Your labs are yours to:

Participant Information

Wellness Snapshot

Consent