(989) 356-WELL (9355)

New Client Application


In order to provide you with the BEST care possible,
PLEASE fill out the New Client Application as
COMPLETELY and ACCURATELY as possible (in BLUE INK)
and submit back to us PRIOR to scheduling your first visit to us!

* DROP OFF at 525 S. State Ave. Alpena, MI or…

* FAX to (989) 340-1030

Once your application has been received and carefully reviewed, we will call to set up an appointment that is convenient for YOU!

Application for Care
Longevity Nutrition Application

Please take the time to watch THIS video BETWEEN your first and second visit to our institute… and consider sharing it with your spouse, significant other,
family members, co-workers and friends!