Discovery Consult

1

Which of these apply to you?* This field is required.What are the things bothering you that you want to change?

I have less muscle and more fat than I want

My mental clarity or memory is not optimal

I have low energy and/or low motivation

My libido or sexual performance is not what it once was

I feel past my prime

I want to age more youthfully

Under age 38

Other

2

Describe other

3

What are your top health or performance goals over the next 6-12 months* This field is required.Be Very Specific.

4

What has been the biggest obstacle to achieving your goals?* This field is required.

5

Best Email* This field is required.so we can contact you

example@example.com

6

Name* This field is required.

First Name

Last Name

7

Cellphone Number* This field is required.

Area Code

Phone Number

8

What do you do for a living?* This field is required.

Entrepreneur, Founder, Business Owner

Executive (CEO, COO, CMO, VP, etc)

Professional (Physician, Dentist, Lawyer, Chiropractor, Finance, etc)

Employee

Retired

9

What did you do before retiring?

10

What significant commitments have you made in yourself in the past?* This field is required.Check all that apply

One-to-one personal trainer, heath coach or concierge physician

High ROI Mastermind or business coach

Hormones, peptides, Hgh, full body scan

Peloton, Tonal, Infrared Sauna, Whoop, Oura Ring

Gym membership, workout plans nutritional supplements

Never invested in any program or service in these categories

Other

11

Describe other

12

Are you willing to hire a concierge physician to help you accelerate your performance?* This field is required.Become the best version of yourself

Definitely!

No

13

High-end customizable services focused on age management, optimizing performance and healthy longevity are rare. They are designed for high net worth individuals with busy lives who are prepared to invest their time, focus and a minimum of $12,000 towards making health a priority. Are you ready to invest in your health?* This field is required.

Yes, I have time and resources now

No, I don't have resources to invest now

14

How soon are you willing to begin investing in your health?* This field is required.

Today!

1 week

Next month

Now isn't the right time, just looking for information

I'm undecided if this is right for me

15

Do you confirm that you will show up to your scheduled call on time and distraction free?* This field is required.

YES, I WILLNO