Wanda W. Chavis
Take care of your body. Its the only place you have to live. -Jim Rohn-
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Application for Consult
Who should apply?
Those who desire to get healthier and become proactive against disease.
Those dealing with specific health issues - interested in alternative medical options or support.
How to apply:
Complete the health evaluation and submit $15 evaluation fee.
How to secure my services after evaluation is acquired:
If application is accepted - I will send a quote for consultation
Submit payment for selected service
I reserve the right to deny an application if I do not feel I can give valid advice, or adequate time and attention to your case.
Wanda W. Chavis, B.S.AltMed, M.P.H.
What is your body saying to you?
I will preview your medical history and issues before determining if I can take you as a client.
Please submit the brief questionaire below - or submit your phone number for a phone accessment.
Please give best day and time to call in the box below.
Address Line 1
Address Line 2
Weight and Height
Surgeries and Date of Surgery
List health issues (i.e.: hypertension, diabetes, etc
Please list your beverage choices - and amount you drink in a 24 hour period
Are you on a special diet or food plan? Summarize:
Have you had a major transistion in the past 6-12 months? Please summarize:
I can call you if you prefer to give medical history over the phone
Best time and days to call
Contact me via email: firstname.lastname@example.org or www.facebook.com/wandachavis