Berkeley Life Direct Consultation Form - Free Book

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What is your name?* This field is required.

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Thank you! What's your email?* This field is required.

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Please tell us what kind of practice you have?* This field is required.An example would be Chiropractic, Functional Medicine, Naturopathic, Family Medicine etc.

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In which state do you operate?* This field is required.

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Thanks for the information so far {name}. Berkeley Life's referral partner program makes Nitric Oxide support easier for you and your patients.

Practitioners earn 30% commission on their recommendations and patients benefit from our clinically supported Nitric Oxide protocols.

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Does your practice currently use a Nitric Oxide test?* This field is required.

YESNO

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Our ability to produce nitric oxide declines as we age, impacting the health of our cardiovascular and circulatory system. The body’s Nitric Oxide levels are linked to supporting normal healthy blood pressure levels, overall cardiovascular health, cognitive function, energy levels, gut health, sexual performance, and more…*

Gerhard et al Hypertension 1996 Celermajer et al JACC 1994 Taddei et al
Hypertension 2001 Egashira et al Circulation 1993.

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Berkeley Life’s patented, non-invasive, saliva-based test strips were specifically designed to indicate salivary nitrite levels, a proven precursor to Nitric Oxide levels in the body. The test strips allow patients and practitioners to indicate Nitric Oxide status in 15 seconds.

When used as part of a patient evaluation the test strips engage the patients on the topic of Nitric Oxide, indicating if their Nitric Oxide levels are low.

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Does your practice currently offer Nitric Oxide supplement protocols?* This field is required.

YESNO

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Two capsules of Berkeley Life Professional provides a plant-based equivalency of dietary nitrate that is in 5oz of spinach and 7oz of beets to provide Nitric Oxide support for a healthy cardiovascular and circulatory system.*

The nitrate-rich proprietary blend is fortified with Potassium Nitrate (KNO3), Beetroot Extract, Organic Fermented Beetroot Powder. The entire formula is enriched with Vitamin C, Thiamin (Vitamin B1), Vitamin B12, and Magnesium.

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What is your best contact phone number?* This field is required.We'll use this to contact you on the day of your consultation.

Please enter a valid phone number.

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What is your preferred contact method?* This field is required.We'll call you on the day of your consultation but it's good to know how best to communicate in the future

SMS

Email

Phone Call

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Good news!

Based on your answers so far it looks like Berkeley Life's Direct to Patient Referral Program and Nitric Oxide Solutions can help you grow your practice.

The next step is to book a free consultation with our account support team

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Book your consultation here* This field is required.

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