Apply for 1:1 Wellness Coaching

Please complete the form below

Name *

First Name

Last Name

Email *

Phone # *

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Gender *

Female

Male

What state do you reside in? *

GI Map stool tests are NOT authorized in N.J, N.Y, and RI.

Desired coaching package *

*Canadians pay an additional $48.00 for any GI Map stool tests due to higher shipping cost.

Dlux Signature Package (4 months) $2,100* USD

GI Map Foundation Package (gut testing) $699* USD

HTMA Foundation Package (mineral testing) $399 USD

I can commit to paying up to $2,100.00 USD for coaching services/support which includes functional testing labs. *

Yes, I can pay in full.

I'm interested in 2 split payments for the Dlux Signature Package

I'm interested in coaching in the future

Have you worked with a functional medicine practitioner before? *

Yes

No

What are your top 3 health concerns? *

How did you hear about Destiny/ Dlux Wellness? *

Ready to invest in your health? *

I'm ready

I'm hesitant

Destiny reviews all applications within 48 hrs of receiving them. Destiny will reach out to you once your application has been reviewed.

Thank you! Destiny will reach out to you in 48 hrs. of receiving your application.

DISCLAIMER

The information/content on this website is intended for informational/ educational purposes only and is not intended nor implied to be a substitute for professional medical advice, or treatment. The information on this website is not intended to diagnose, treat, prevent, or cure any disease, illness, or health condition. Always consult with a qualified medical professional if you have any medical questions or suspect you may have a medical condition. Never disregard or delay seeking medical advice because of something you have seen or read on this website. These statements on this website have not been evaluated by the Food and Drug Administration.

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