New Clients New Clients Start Here: Welcome to 21st Century Total Wellness! If you’re ready to get started as one of our clients, there are four steps to follow: 1. Legal Disclaimer & Scheduling Policy Click here & complete Note: Please do this step first – this must be fully completed prior to placing orders and before consultation services can be rendered. 2. FirstLine Therapy (FLT) Health History The second step is to provide us with a FirstLine Therapy (FLT) Health History. There are two ways this can be done: Online Submission of Health History Download PDF of Health History Form — this you will fill out and fax or mail to our office. 3. Health Appraisal Questionnaire The third step is to fill out our Health Appraisal Questionnaire. Due to the length of this particular form, we have broken the online submission option into sections. On this section you also have the option to do an online submission or to download the PDF below to fill it out and fax or mail it to our office. Please complete all sections that apply: Parts 1-5 (Everyone fills out this section.) Parts 6-10 (Everyone fills out this section.) Parts 11 (Male clients only fill out this section.) Parts 12 (Female clients only fill out this section.) Download PDF of Health Appraisal Questionnaire — this you will fill out and fax or mail to our office. 4. Select Phone or Office Consultation & Pay Appropriately New Client Phone Consultation The New Client Phone Consultation consists of the following: Review Health History Set-up Labwork, if needed. Review current Nutrition & Supplement practices. Establish your Personalized Plan of Care Please fill out the form to schedule your consultation! $75.00 to $95.00 with Plan Of Care New Client Office Consultation The New Client Office Consultation consists of the following: Review Health History Set-up Labwork, if needed. Review current Nutrition & Supplement practices. Review any current muscular/skeletal concerns. Physical examination, if requested. Intervention(s) for pain based on initial appointment protocol. Please fill out the form to schedule your consultation! $150.00 to $180.00 with physical examination & Plan Of Care Make An Appointment Name*Email* Phone*Type of Consultation*PhoneOfficeAppointment Type* Free Initial Phone Consultation New Client Appointment Existing Client Appointment Requested Date & Time for Appointment / Comments*Let us know you are human 1) BASIC POC INCLUDED WITH INITIAL NEW CLIENT: $120-$150 PHONE CONSULTATION (PHC) OR IN OFFICE APPOINTMENT (IOA) GENERAL NUTRITIONAL GUIDELINES & SPECIFIC SUPPLEMENTATION & DISPENSARY UPDATES REVIEW LABS ADDITIONAL $10-$25 (1-5 Clients choose this option) 2) CUSTOMIZED POC INCLUDES: $140-$180 PHC OR IOA ~ SPECIFIC TO YOU: A) NUTRITIONAL/SUPPLEMENTATION/DISPENSARY RECOMMENDATIONS B) 2 WEEKS OF TELEMEDICINE (TM) TEXT/EMAIL FOR FOLLOW UP Q/A C) REVIEW LABS ADDITIONAL $25-$50 (75% of the clients who choose this option initially, end up adding 1 TM/PHC FOLLOW UP FOR Q/A &/or UPDATES TO POC) 3) SPECIALIZED POC INCLUDES: $150-$200 PHC OR IOA ~ SPECIFIC TO YOU: A) NUTRITIONAL/SUPPLEMENTATION/DISPENSARY RECOMMENDATIONS B) 2 WEEKS OF TELEMEDICINE (TM) TEXT/EMAIL FOR FOLLOW UP Q/A C) 1 TM/PHC FOLLOW UP FOR Q/A &/or UPDATES TO POC D) REVIEW LABS ADDITIONAL $50-$95 (As of Jan 2022 ~ 99% of clients who choose this option initially, are satisfied with their progress & continue with updated POC as needed) 4) Comprehensive Total Body Physical & Wellness Evaluation (CTBP&W) ~ INCLUDES: SILVER OPTION $2300 (INCLUDES 2 separate IOA) GOLD OPTION $4400 (INCLUDES 3-4 separate IOA) BOTH SILVER & GOLD OPTIONS INCLUDE THE FOLLOWING: Blood Work (Lab’s $500-$1500) Muscular Skeletal (IOA/HAQ $400-$600) · Digestive/GI/Colon (IOA/HAQ & Lab’s $250-$350) · Cardiovascular/Pulmonary (IOA/HAQ $400-$600) · Neuro/Cognitive (IOA/HAQ & Lab’s $250-$350) Cellular/Genetic Profiling (HAQ & Lab’s $500-$1000) (As of Jan 2022 ~ 100% of the clients who choose this Comprehensive Evaluation are satisfied with their progress & continue with updated POC as needed) ROUTINE CLIENTS IOA $110-$170 (Can include consultation, hands on, POC Q/A) PHC $100-$120 (Can include consultation, Lab review, POC Q/A) INDIVIDUAL/PAY AS GO PHOTON GENIUS (PGM) SESSIONS $65-$95 DISCOUNTED PACKAGES FOR PGM SESSIONS GO TO OUR SERVICES LINK https://www.21ctw.com/services/ IOA= IN OFFICE APPOINTMENT PHC= PHONE CONSULTATION HAQ= HEALTH APPRAISAL QUESTIONNAIRE TM= TELEMEDICINE Payment is made at time of service, or prepaid options for discounted plans available IOA hours are By Appointment Only: Monday – Thursday, 9:15 am to 6:30 pm CST and Friday 10:00 am to 4:00 pm CST. PHC are available: Monday – Friday, 9 am to 9 pm CST. Personal training sessions are available following a Specific Determination Evaluation (SDE). These training sessions can include: Strength & Conditioning, Self-Defense, Total Body Fitness. All sessions are focused on exactly what you need, ask about our guarantee with all private sessions.