HELP IS ON THE WAY!

This Special Limited Time Offer Price is Only $XXX.00... $XXX

Apply For Your Online Consultation

We take on a limited number of telehealth cases to provide the best, personalized care. Someone from the team will contact you regarding your interest.

We only want SERIOUS applicants. Please do NOT submit your application unless you are completely committed to the time, money, and ready to implement what you learn to get results from this program.

You currently have the recipe for suffering. If you continue what you are doing right now, you will continue to suffer. If you are ready to make changes and stop suffering, fill out this form and we will get back to you.

First Name *

Last Name *

Phone *

Email *

Country

What specific health challenges or symptoms are you currently experiencing? (Provide a brief description) *

What do you hope to accomplish with functional medicine? (click all that apply) *

Identify root causes of my symptoms

Develop a tailored nutrition and lifestyle plan

Get a second opinion on previous diagnoses

Understand more about my overall health

What other treatments or strategies have you tried to address your health concerns? (Provide a brief list or description)

Are you currently prepared to invest in improving your health through functional medicine? *

Yes, I'm ready to invest in my health and make a change now.

I need more information on what's involved.

I'm exploring options and am not ready to commit to a plan of action.

Feel free to provide any additional details or ask any questions you might have:

I agree to the terms. By providing my phone number, I agree to receive text messages from Ronel Corbin or her team at Healing Elephant Acupuncture & wellness Clinic.

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