Apply to Become A Patient At Zuma Wellness.

Welcome! Thank you for your interest in becoming a patient. Please fill out this application. We will be in touch, usually within 2 business days, after we receive your application.

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* 1. Please complete this Basic Info about yourself?

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* 2. A) What are your main health concerns? B) Please list any other health concerns that are part of your health picture?

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* 3. What treatments have you already tried or done for your main health concerns? Did they help? What were the outcomes?

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* 4. How quickly do you expect to be ably to resolve these issues after initiating a treatment plan?

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* 5. Do you smoke cigarettes? Do you exercise? Do you eat well?

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* 6. How ready and willing are you to make changes to your nutrition and lifestyle, if needed, on behalf of your health?

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* 7. How ready and willing are you to follow a supplement plan - i.e. take natural medications that the doctor deems necessary on a daily basis - on behalf of your health?

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* 8. Are you willing to get labwork and tests done if the doctor deems it necessary?

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* 9. Do you understand that we don't take insurance? Do you also understand that this is often not a one visit/ quick-fix type of medicine and multiple visits may be necessary to resolve your issue(s)? Are you committed to undergoing and able to finance multiple visits if needed?

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* 10. Do you have any questions/ concerns that you need answered before you are accepted as a patient with us? Or any final comments?

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