Survey - Biologix Center for Optimum Health

Complete this form to schedule a conversation with our Patient Care Coordinator. They will answer your questions and direct you how to receive a Case Review.
What's your name?*
First Last
What is your email so that we can save your answers?*
Would you like to sign up for our mailing list, where you can receive exclusive offers and special updates?
- Yes
What is your Zip/Postal Code?*
ZIP / Postal Code
What is the best number for us to reach you to discuss your survey results?*

How many doctors have you already seen for your condition?*
- 1-10
- 10-25
- 25-50

Do you feel that your previous doctors dismissed, ignored, or disregarded your specific needs and/or symptoms?*
- Yes
- No
How? (Optional)

Now we’d like to tell you a little bit more about what we can do to help you find true healing!

We are doctors of last resort, meaning that we will go above-and-beyond all of your previous doctors efforts combined to discover the root causes of your symptoms within daily, one-on-one, hour-long sessions until we find you lasting relief.

Our all-inclusive, cost-effective treatment programs last between one and four weeks.

Your length of stay will depend on both the severity of your symptoms and your personal schedule. We do, however, require that our patients visit us for at least one week so that we have enough time to learn your body and discover how best to begin its healing.
Are you capable of traveling to our center in Nashville, Tennessee?*
- Yes
- No

The Biologix Center does not accept insurance. Most patients can start with a two-week program which costs $12,500. However, for international or severely ill patients, we require a three-week program. Four-week programs are also available for those that need it.
Are you able to pay for your treatment out of pocket?*
- Yes
- No
*If not, please continue — you have options!

We can offer you a 0% Interest Plan for 6 months.

For those who qualify:

We offer a 6-month extended payment program at 0% interest through CareCredit!

We also offer partial scholarships through a not-for-profit foundation that can be used IN ADDITION to the Care Credit payment plan.
Would you like to take advantage of CareCredit’s 6-month, 0% interest payment plan?*
- Yes
- No
Would you like to take advantage of CareCredit’s 24-month, 14.9% interest payment plan?*
- Yes
- No
Would you like more information about the Biologix Scholarship program?*
- Yes
- No

Awesome! On paper, it looks like you are a fantastic candidate for our treatment center. But in order to become a patient, you will need to speak with our Patient Care Coordinator first.
What is the best way to contact you?*
- I would prefer calls.
- I would prefer emails.
By checking "I would prefer texts" you are consenting to be contacted by Biologix Center via SMS text regarding your free consultation.
Phone
This field is for validation purposes and should be left unchanged.

Title