Request a Free 15-Minute Connection Call

Let’s Explore Your Path to Vibrant Health

Dr. Max is dedicated to helping you uncover the root causes of your health challenges and reclaim your vitality. Because we dedicate focused, individual energy to every single patient, spaces for these connection calls are strictly limited.

Please complete the brief application form below. Our team manually reviews every request to ensure that Dr. Max’s unique approach is the absolute best fit for your specific health goals and timeline.

Basic Info

Full Name *

Email *

Phone *

What is your age? *

18-24

25-34

35-44

45+

Health Goals & Struggles

Others (please specify)

What have you already tried to solve this issue? (Check all that apply) *

Conventional medicine

Functional/holistic medicine

Dietary changes

Lifestyle changes (stress management, exercise, sleep improvements)

Nothing yet—I don’t know where to start

Others (please specify)

Where are you feeling stuck right now? (Check all that apply) *

Lack of time

Lack of motivation

Not sure what to do next

Tried many things but nothing is working

Others (please specify)

How important is it for you to reach your health goals? (1 = Not urgent, 5 = Extremely urgent) *

Before We Schedule

This work involves time, consistency, and an out-of-pocket investment. Are you currently in a place where you could move forward with that if it feels like a good fit? *

Yes

No

Maybe

This is a brief 15-minute connection call to understand your situation and determine whether working together would be appropriate. It's not designed to provide treatment plans, protocols, or medical advice.

You selected "Maybe." Please briefly explain what's holding you back from moving forward right now and what would need to change for this to become a "yes". *

Other info

SMS Notifications for Appointments *

Check this box to receive SMS reminders for your call

If other, please specify below

Please share anything that will help prepare for our meeting. *