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 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 Appointment Time: Approximately 30 minutes, $45.00 Please fill out the form to schedule your consultation! Please pay for your appointment using the Pay Now button below. 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. Appointment Time: Approximately 75 minutes, $95.00 Please fill out the form to schedule your consultation! Please pay for your appointment using the Pay Now button below. 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 Appointments Office/clinic hours are by appointment only: Monday – Friday, 9:15 am to 6:30 pm CST. Phone consultations are available: Monday – Friday, 11 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.