let’s connectwork with me Complete this form to schedule Name * First Name Last Name Email * Phone * (###) ### #### Date of Birth * Why Do You Want To Work Together? * Investment * Working with Dr. B requires commitment and adherence to treatment plans outside of our appointments. Visit/package prices range from $425-$2,350. Are you motivated and able to make this level of investment in yourself? Yes! No. Scheduling * Meet & Greet calls occur every Friday from 10am-2pm. What time do you prefer to be scheduled? 10:00am 10:15am 10:30am 10:45am 11:00am 11:15am 11:30am 11:45am 12:00pm 12:15pm 12:30pm 12:45pm 1:00pm 1:15pm 1:30pm 1:45pm You will be contacted shortly to confirm your appointment. DrB.NMD@NewEveHealth.comGilbert, Arizona