Initial Consult with Dr. Tenesha Wards - WSCongratulations on applying! Please fill out the application, submit the initial consult payment, and select an appointment time on my calendar. If we are a fit, I look forward to working with you very soon.Thank you, Dr. TeneshaName(Required) First Last Email(Required) Phone(Required)Who referred you? Or how did you hear about us?(Required)What State are you located in?(Required)AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificWhy is having this consult a MUST right now?(Required)Did you watch Dr. Wards' The Infinity Way™ Chronic Fatigue Webinar?(Required) Yes No(If not, a link will be in the follow up email to watch and learn more about what we do)What are the top 3 challenge you're facing when it comes to your health?(Required)How long have you suffered with these symptoms?(Required)On a scale of 0-10 how severe is your main symptom? 10 means they affect your daily life and ability to do things in need to do to function. 1 means hardly noticeable day to day, or notices less than 1/week.(Required)012345678910What are your biggest fears and frustrations when it come to your health?(Required)What are your biggest hopes and desires when it comes to your health?(Required)What treatments, coaching or other programs have you purchased to overcome this in the last 6 months?(Required)What supplements and medications are you currently taking and why?(Required)Tell me a little bit about your business, profession or daily responsibilities.(Required)How much money do you think you are losing per month as a result of your fatigue/other symtoms?(Required)What are some activities you are missing out on due to your level of fatigue?(Required)When it comes to your health are you the sole decision maker?(Required) Yup! I don't need to talk to anybody else. No...but my significant other is on board and agreed I can make a decision. No, I rely financially on my partner and must talk to them.How much money have you spent trying to fix this problem in the last 2 years?(Required)Are you in a position to make an investment to take control over your energy and health?(Required) Yes, I am ready! It's time. NoDo you believe finding time or money is a valid excuse for not reaching your goals?(Required) No, I always find the time and money when things matter to me enough. Yes, I seldom have time or money for the things I want to do.Dr. Wards works with patients in a 3 or 7 month program that includes functional medicine lab tests, nutrients needed, functional nutritionists, and mindset coaches. Our programs can be a considerable investment in YOUR health to truly heal. Are you willing to invest in yourself if the System is a perfect fit?(Required) Yes! I’m ready if it makes sense let’s do this. No, I’m not there yet.What have you tried already that has worked or not worked, or there anything else you would like to share to help us make the most of our time together?(Required)Δ
