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NEW PATIENT DISCOVERY CALL REQUEST

Please fill out the following form in order to book a “discovery” call with one of our staff. This 15-minute complementary call will allow you to explore our services further and establish if we are a good fit for you!

How did you here about us

What would you like to discuss with us here about us

Choose all that apply

Are other people in your family potentially affected by mold/CIRS?

If you answered “Yes” above:

How many? Ages Relationship to each

Have you enrolled in TRUTH & TRUST FOR MOLD, CIRS, BIOTOXINS, AND MULTIPLE MYSTERIOUS SYMPTOMS  ALL ACCESS program?

If you answered Yes to enrolling in Truth & Trust, please tell answer the next two questions. If you answered “no” or “unsure” you can skip the next two questions.

1. Is the name on that subscription the same as the one listed above?

 

2. If so, have you viewed videos 1, 7, 8, and 16 (which are strongly suggested before starting care with us)?

For a 15 min discovery call with no obligation or purchase is required.

For a 1 hour consultation, it is either $350 or complimentary if you have purchased the Truth & Trust program.

Please select preferred date and time and one of our staff members will contact you to confirm your appointment or provide an alternative.

Thanks for submitting!

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EBHC LOGO FINAL

6101 Chapel Hill Blvd.

Suite 206

Plano, Texas 75093

Call To Find Out How We Can Create A Plan For You!

(972) 378-0120

FAX (972) 378-0131

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Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.

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