The following questions are about much more than eliminating your symptoms—it's about living a life of vibrant wellbeing. 

Please answer the following questions so we can better assess how we can help you. After, we will be in touch with information on becoming a patient.

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* What is your primary health concern?

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* Please briefly describe your primary reason for coming to see us and be as specific as possible:

Readiness Assessment
In order to improve your health we want to know how willing you are to do the work? Please rate on a scale of 1 (not willing) to 5 (extremely willing).

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* Modify diet based on lab testing

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* Take nutritional supplements based on lab results

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* Keep a record of everything you eat certain days

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* Modify your lifestyle (e.g., work demands, sleep habits)

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* Practice a stress-management technique

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* Engage in regular exercise

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* How coachable are you?

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* Please provide your name:

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* Please provide your email address:

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