Check Your Eligibility
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✔️ Safe Matching
We check your health details to make sure our treatments are a safe fit for your specific condition.
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✔️ Full Commitment
We only take on clients who are ready to take immediate, active charge of their recovery
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✔️ Results-Driven
Your treatment plan is built entirely on your real blood work, completely removing the guesswork.
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✔️ Private & Confidential
Everything you type inside this form is secure and protected under strict clinical privacy.
Private Clinic Intake Portal
Your Path to Recovery.
01
YOU ARE HERE
Fill out the 2-minute form to confirm your condition is a safe, approved match for our 12-week care.
02
CHOOSE YOUR PATHWAY
Once approved, go straight to our program menu and select your delivery track (In-Clinic, Hybrid, or 100% Online)
03
BEGIN YOUR TIMELINE
Unlock your full 12-week care plan, receive your custom-compounded medicine supplies, and your healing timeline goes live
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 clinical 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.