Nature of Your Inquiry*
---Would like to schedule an appointmentWold like to speak to someone

Your Primary Health Concern*
---Adrenal FatigueAlzheimer'sAutoimmune DiseasesBrain FogCancerDementiaDetoxificationEpstein BarrFatigueFibromyalgiaGut IssuesHeavy Metal ToxicityInflammationJoint PainLeaky GutLupusLyme DiseaseMold TreatmentMultiple SclerosisNeurological DisordersPainParkinson's DiseaseShinglesThyroid DiseaseOther
Add comments about your condition

First Name*

Last Name*

City*

State*
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Email*

Phone*

Best Time To Call

How did you hear about LifeWorks?*

Please send me related health info.

I UNDERSTAND AND AGREE THAT:

I am not an existing patient of LifeWorks.
I will have to travel to Clearwater, Florida for a consultation, lab-testing and treatment
LifeWorks does not accept medical insurance Medicaid or Medicare
I will have to pay for my initial consultation at the time of scheduling
I may be required to stay in Florida for the duration of my treatment
LifeWorks does not refer patients to other clinics