During this call, you will be able to provide details about your current health challenges & symptoms. Dr. Jen will then provide you with information explaining root causes of inflammation & symptoms as well as provide first steps together to begin to change your current health status FOR GOOD!

This time serves you & Dr. Jen to determine if you would be a good fit to work together further & benefit from her Symptom-LESS Program or individual medical consultation.

This call does not serve as medical advice, this call is ONLY for serious inquiries seeking a practitioner- patient relationship.

This call may also take place with our nurse Jesi if Dr. Jen’s schedule is completely booked so we can get you seen sooner rather than later :)

{Discovery Call is via phone or zoom- submit information then receive link to scheduler}

Please take a few minutes to watch this video before you submit your application!

All service pricing can be found here.

All testing pricing can be found here.

Name

First Name

Last Name

Email Address

Address

The following information I will need to order any testing or send supplies to your home

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Date of birth

MM

DD

YYYY

Gender/Pronouns

(select Male/he Female/she other/they)

How did we get connected?

If referred, please provide their name so we can thank them!

What are your top health goals in the next 3 months?

Please be specific.

What has been your biggest struggle reaching those goals?

If you could get rid of 3 problems related to your physical or energetic health keeping you from fully showing up in life, what would they be?

Are you willing to get speciality lab testing to uncover the root cause of your ailments?

(Note: this can all be done in the comfort of your home or nearby draw center!)

On a scale of I - 10

(with 1 being the least, and 10 being the most), how motivated are you to find a solution to your problems?

I understand Dr. Jen is here to hold my hand,

present me with information + tools for my healing AND I take full responsibility for the results of my healing by implementing those tools!

I understand!

I am not ready for this level of a healing container!

The investment to work with Jen can vary based on your customized protocol and testing needed. The minimum investment to begin is $300-899.

(Keep in mind I do not take insurance but do accept HSA/FSA payments. Some lab work is reimbursable by insurance.)

Yes

No

In order to provide the utmost comprehensive and customized care for my clients,

I only accept a limited number of new clients per month for my program. If we decide to work together, when would you be able to start?

MM

DD

YYYY

I have watched the video above and understand the information presented below.

Please note, we reserve the right to cancel any appointment made after reviewing the application. Please note, this call is a free introductory time before beginning work together. Should you choose not to book a session within 24 hours a $99 charge will apply.

Yes, I have watched the video & I agree to the terms presented on this page.

No, I do not wish to submit my application at this time.

I ensure the demographics provided are correct and appropriate to use for my lab testing.

Yes, good to go!

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