Check Your Eligibility
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âī¸ Safe Matching
We check your health details to make sure our treatments are a safe fit for your specific condition.
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âī¸ Full Commitment
We only take on clients who are ready to take immediate, active charge of their recovery
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âī¸ Results-Driven
Your treatment plan is built entirely on your real blood work, completely removing the guesswork.
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âī¸ Private & Confidential
Everything you type inside this form is secure and protected under strict clinical privacy.
Private Clinic Intake Portal
Your Path to Recovery.
1
YOU ARE HERE
Fill out the 2-minute form to confirm your condition is a safe, approved match for our 12-week care.
2
CHOOSE YOUR PATHWAY
Once approved, select your 12-week Care Program & your preferred delivery method (In-Clinic, Hybrid, or 100% Online)
3
BEGIN YOUR RECOVERY
Unlock your full 12-week Care Program, receive your custom-compounded medicine supplies, and begin your journey to recovery.
FAQs
Why We Screen Our Patients
1
We strictly limit our intakes to people who are completely ready to invest in their health outcomes. This brief screening confirms your condition is a safe match for our hardware and keeps our schedule open for committed clients.
What happens after I submit this form?
2
We check your health details instantly. If your condition is a safe match for our specialized 12-week care, you will go straight to our program page where you can choose your pathway and join immediately.
What if I am not eligible for a full program?
3
If your case is not a fit for our full 12-week care, you are still looked after. You can go straight to our public shop to buy our everyday retail Care Balms and Botanical Teas without needing an approval.
Is my private information secure?
4
Yes, 100%. Everything you type inside this form is fully encrypted, completely private, and safely hidden away behind secure clinical database walls.