Health & Wellness Services
We are delighted that you have chosen to apply to be considered for one of our unique  Health & Wellness programs. There are limited spaces available for new clients and therefore require an application process. Your answers below help us determine if you are a fit for one of our programs. Please be thorough when answering.

Once you complete the application we'll be in touch with our decision and next step.

Thank you for your interest!
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Name *
First and last name
Email *
Phone number *
Tell us about your current health? *
Why do you want to be considered for one of our health & wellness programs? *
What is the biggest challenge you are facing right now in obtaining optimal health & wellness naturally? *
What current supplements and/or medications do you take on a regular basis? *
How frequently do you visit your medical doctor? *
Why is NOW the time to take action towards your health and wellness in a different way than you've tried before? *
How willing are you to work towards shifting your mindset to obtain optimal health and wellness? (This may require you to let go of old mindsets) *
What type of investments are you willing to make in obtaining optimal health & wellness? *
Required
Who may we thank for referring you? *
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