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The Lotus Concept Wellness
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  • Home
  • Our Team
    • Our Team Of Practitioners
  • Our Offerings
    • Coaching Consultations
    • Signature Programs
    • Online Courses
    • Meal Plans
    • Trichology/Hair Loss
    • Tapping / EFT
    • HeartMath
    • CRM Meditation
  • Scheduling
    • Scheduling
  • All Consultation Forms
    • EFT Discovery Session
    • I5 Min Wellness Consult.
    • 15 Min.TrichoWell Consult
    • HealthWell Consult Forms
    • Tricho-Well Consult Forms
  • Our Store
    • Products/Programs/Books
    • Supplement Dispensary
    • Lab Testing
    • Specials
  • Blog
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  • In the Media
    • In The Media
    • Videos
  • Resources
    • Some Personal Favorites
  • More
    • Home
    • Our Team
      • Our Team Of Practitioners
    • Our Offerings
      • Coaching Consultations
      • Signature Programs
      • Online Courses
      • Meal Plans
      • Trichology/Hair Loss
      • Tapping / EFT
      • HeartMath
      • CRM Meditation
    • Scheduling
      • Scheduling
    • All Consultation Forms
      • EFT Discovery Session
      • I5 Min Wellness Consult.
      • 15 Min.TrichoWell Consult
      • HealthWell Consult Forms
      • Tricho-Well Consult Forms
    • Our Store
      • Products/Programs/Books
      • Supplement Dispensary
      • Lab Testing
      • Specials
    • Blog
    • Contact
    • In the Media
      • In The Media
      • Videos
    • Resources
      • Some Personal Favorites
The Lotus Concept Wellness

Signed in as:

filler@godaddy.com

  • Home
  • Our Team
    • Our Team Of Practitioners
  • Our Offerings
    • Coaching Consultations
    • Signature Programs
    • Online Courses
    • Meal Plans
    • Trichology/Hair Loss
    • Tapping / EFT
    • HeartMath
    • CRM Meditation
  • Scheduling
    • Scheduling
  • All Consultation Forms
    • EFT Discovery Session
    • I5 Min Wellness Consult.
    • 15 Min.TrichoWell Consult
    • HealthWell Consult Forms
    • Tricho-Well Consult Forms
  • Our Store
    • Products/Programs/Books
    • Supplement Dispensary
    • Lab Testing
    • Specials
  • Blog
  • Contact
  • In the Media
    • In The Media
    • Videos
  • Resources
    • Some Personal Favorites

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15 Minute Free Consultation Forms

15 Minute Free Consultation

Consultation Form Instructions:

We are a paperless practice; our website, email and virtual conferencing platform are secure for conferencing, payment and the transmission of your records and information. If you have questions please don't hesitate to give us a call.  


All clients must complete the following  forms and return them prior to their scheduled appointment time. 

Schedule your appointment by going to Schedule & Payment.  

We do hope you consider our programs to find your own ANSWERS, RESULTS & HOPE.

schedule your 15 min. free consultation

My Story

Instructions:

Your Story

The purpose of this form is for you to give a little more background information about yourself, condition, etc. 

In your own words please tell me "your story". Take as much space as you need. Please include the follow:

  •  When did your health challenges begin and how long before you sought help?
  • Did you get a diagnosis and medication? If so, what was the diagnosis, how often have your medications and dosages been changed?

FYI: It's most helpful if the information is given in a timeline formate.

Disclaimer of Liability

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The Lotus Concept Wellness

1-888-255-4159

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