Name *

First Name

Last Name

Have you worked with alternative, naturopathic or holistic practitioners before? *

Yes, one or a few.

No, but I'm open and ready for a new approach. I understand this will be a very different experience from a standard medical approach or even a standard functional/naturopathic approach.

No. Only standard medical practitioners. I'm most comfortable with this approach.

Scheduling & Investment *

Check the boxes to confirm you understand.

All sessions are online for ease of connection wherever you are in the world.

You have the choise of one 75 minute session or two 45 minutes sessions a month.

The Concerige Reset is $999/month. A rolling membership that can be cancelled or paused anytime with 30 day notice.

Labs & supplements are a separate investment.

Care provided is outside insurance coverage.

In our partnership, you will invest your time, energy, emotions, thoughts, and money in new ways that prioritize the highest value – your complete health. Are you ready for this? *

Yes! I feel like I already do this regularly, but I'm missing something or want to take it deeper and I can't wait to identify this with you!

Yes, yes, yes. I'm so ready for this. I cannot wait to begin the process and come out the other side my truest self! Thank you for giving me this opportunity to show myself how truly worthy I am of all my resources!

Yes, I'm ready, but a little nervous. I've never dived this deep and the unknown feels a bit scary, but at the same time I want the results and I am ready to put in the investment to get there.

No. I can feel that I'm not ready to fully prioritize myself. I sense resistance in me that I'm not in the season to navigate. I know I'm always welcome back when I'm ready.

Select the number that best represents how committed you are to doing whatever it takes to restore yourself. Scale from 1 - 5, with #5 = I'm 110% Here For This and #1 = Not Very Willing. *

5

4

3

2

1

Do you believe you will experience healing through our partnership? *

Yes

No