JOIN OUR REVITALIZE FAMILY TODAY!

NEW CLIENT PAPERWORK

Revitalize Weight Loss & Wellness Center offers our client form(s) online so they can be completed in the convenience of your own home or office.

All forms are PDF files. You will need AdobeReader® to view them.
If you do not already have AdobeReader® installed on your computer, Click Here to download.
Download the necessary form(s), print them out and fill in the required information.
Fax us your printed and completed form(s) or bring them with you to your appointment.

Revitalize Weight Loss & Wellness Center offers our client form(s) online so they can be completed in the convenience of your own home or office.

All forms are PDF files. You will need AdobeReader® to view them.
If you do not already have AdobeReader® installed on your computer, Click Here to download.
Download the necessary form(s), print them out and fill in the required information.
Fax us your printed and completed form(s) or bring them with you to your appointment.

New Client Paperwork – Click Here to Download

PROGRAM PRICING

If we decide together that our program is a good fit for you, we offer a variety of payment options ranging from one-time payments to monthly payments in order to suit your specific situation. Program fees can range anywhere from $125 to $180 per month if financing monthly payments. During your consultation, there is no pressure or obligation to enroll. Schedule now to find out how our comprehensive approach to weight loss can be the last program you ever need.

We accept all medical reimbursement accounts such as Health Savings Accounts (HSA) and Flex Spending Accounts (FSA). We also accept CareCredit.

Schedule a Consultation