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Intake Form

Please download and fill out the form and email it to 

PLEASE NOTE: The health information given during this consultation is for general education and is not in attended to be specific medical advice.  No medical care, diagnosis, or treatment is provided during this consultation.  It is advisable to consult with one’s personal, health. Care provider before implementing any lifestyle changes.


I release Dwelling at the Tree of Life, Lifestyle counselor and/or associated organizations from any/all liability resulting from accepting this assessment. 

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