Application For THE FOREVER PLAN

The goal of this application is to see if I can help you with your health concerns and if we are a good fit to work together.  I believe no matter your current health situation your body has the ability to feel better than you ever thought possible.

- Denise Locsin


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Email *
Name:
Phone Number: *

What is your main health challenge or complaint?

What have you tried so far to get relief that has not worked?
How does this affect your life?
What would you like to achieve while working with me?
On a scale of 1-10 how motivated are you to do what you need to feel better?
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