Use this form to become a new patient. Our friendly staff will contact you in the next few business days.

*Birthday

*Are you willing to work with Joseph Debban APRN and staff, to follow the "Take It Back Method" for the best results and outcomes? Generally speaking you should plan on at least 6 months of treatment.

*Are you willing to see Joe every 3-4 months to monitor your journey?

*We are a direct-pay practice as insurance does not typically cover our services and we do not participate with insurance networks. This allows us to offer services at significantly lower costs. Are you willing to participate in a cash pay practice?

*Due to high demand, we are booking new patients out 2 months. Are you still interested in becoming a patient?

*Also do to high demand, we require a credit card on file to hold your appointment. Are you aware if you miss your appointment or cancel without 24 hour notice a $150.00 fee will be applied?

*Ahead of your first visit you will receive an email with information and intake forms. This is important and how we get to know you. Can you receive email and complete the forms?

*I understand intake is 2 steps. The Wellness Intake with an RN to draw labs, review health history, medications, complete assessment forms ($200). Your Wellness Strategy Session is with Joe to review options and see if you would like to proceed ($130).