Skip to content
ABOUT
Meet Our Providers
Technology
Hear From Our Patients
LOCATIONS
TMJ/ HEAD &
FACIAL PAIN
SLEEP DISORDERS
TONGUE TIES
HOLISTIC SOLUTIONS
Regenerative Medicine
CONTACT
Contact Us
Careers
Referring Patients
Menu
ABOUT
Meet Our Providers
Technology
Hear From Our Patients
LOCATIONS
TMJ/ HEAD &
FACIAL PAIN
SLEEP DISORDERS
TONGUE TIES
HOLISTIC SOLUTIONS
Regenerative Medicine
CONTACT
Contact Us
Careers
Referring Patients
Home
ABOUT
Meet Our Providers
Technology
Hear From Our Patients
LOCATIONS
TMJ/Head & Facial Pain
Tongue Ties
Sleep Disorders
Holistic Solutions
Regenerative Medicine
CONTACT
Contact Us
Careers
Referring Patients
Menu
Home
ABOUT
Meet Our Providers
Technology
Hear From Our Patients
LOCATIONS
TMJ/Head & Facial Pain
Tongue Ties
Sleep Disorders
Holistic Solutions
Regenerative Medicine
CONTACT
Contact Us
Careers
Referring Patients
Patient Portal
Book Appointment
Wellness Workshop Survey
I am most interested in my:
*
Structural / Physical Health
Emotional / Spiritual Health
Chemical / Nutritional Health
I spend _____ a week taking care of my Structural / Physical Health.
*
1-3 Hours
3-6 Hours
6 + Hours
This includes but not limited to cardiovascular exercise (walking/jogging/running), yoga, weight lifting, recreational sports (basketball, soccer) and physical therapy.
I am:
*
Happy with the amount of time I dedicate to my Structural / Physical Health.
Would like to increase my time to my Structural / Physical Health.
I spend _____ a week taking care of my Emotional / Spiritual Health.
*
1-3 Hours
3-6 Hours
6 + Hours
This includes but not limited to worship, meditation, recreational reading, counseling and volunteering.
I am:
*
Happy with the amount of time I dedicate to my Emotional/Spiritual Health.
Would like to increase my time to my Emotional/Spiritual Health.
I spend _____ a week taking care of my Chemical / Nutritional Health.
*
1-3 Hours
3-6 Hours
6 + Hours
This includes but not limited to meal planning and prepping (healthy foods of course), nutritional research/counseling and related events.
I am:
*
Happy with the amount of time I dedicate to my Chemical / Nutritional Health.
Would like to increase my time to my Chemical / Nutritional Health.
PLEASE FILL OUT THE SHORT FORM BELOW AND WE WILL BE IN TOUCH.
I would most likely attend an event on the following topic:
*
Structural / Physical Health
Emotional / Spiritual Health
Chemical / Nutritional Health
I am also interested in learning more about Pediatric Sleep Disordered Breathing*
*
Yes
No
Name
*
First
Last
Email
*
Phone
CAPTCHA
