What are your primary health concerns that you are looking to address (select all that apply) *

Gut & Digestive Issues

Skin Issues (Acne, Eczema, Rashes, Rosacea)

Weight Loss & Body Recomposition

Hormonal Imbalances

Autoimmune Conditions

Mold Exposure / Chronic Infections (Lyme, co-infections)

Mental Health & Nervous System Regulation (anxiety, depression, burnout, stress dysregulation)

Other

How did you hear about us? *

What sparked your interest to apply? *

What's your primary goal? *

How long have you been struggling with these issues? *

Have you done functional medicine before? *

Yes

No

If yes, describe your experience. Did it work? *

On a scale of 1-10, with 1 being "I'm content with my body and health" and 10 being "I need to make a change now," where do you fall? *

Our practice is a high-level, root-cause experience. Most clients come to us after years of not getting answers or results elsewhere. Our work is comprehensive, deeply customized, and designed to resolve the actual drivers of your symptoms and then optimize your biology from the inside out. Because of the depth of testing, clinical expertise, and ongoing support involved, we are not the lowest-cost option. It is, however, the most effective path for people who are ready to solve this properly. What level of investment are you prepared to make to resolve this at the root - once and for all?* *

I want to solve the problem. Money is not an issue, the result is the most important thing to me.

I am price sensitive, but I am mainly concerned with solving the problem once and for all.

I am very price conscious - I want to solve the problem but I need to make sure it fits within my budget - I would likely need to use financing options.

I am unable or unwilling to invest at this time. (please apply again when the time is right).

First Name *

Last Name *

Phone *

Email *

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By checking this box, I consent to receive marketing and promotional messages including special offers, discounts, new product updates among others, from Redmond Functional Health at the phone number provided. Frequency may vary. Message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

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