Contact Us Now To book your FREE consultation Full Name Date Of Birth MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Day01020304050607080910111213141516171819202122232425262728293031 Year2020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900 Phone Number Email Consultation Preference AnyIn PersonTelephone Clinic Location Preference Choose LocationNorth York (200 Finch Ave. West, Suite 108)Mid Town (1910 Yonge Street, Suite 101) Please indicate which program you are most interested in learning aboutNaturopathic Weight Loss using a whole-food approachThe Ideal Protein ProgramPersonal Training and/or Personalized Training PlanWeight Loss AcupunctureBody Contouring and Cellulite Reduction Treatments List any other health concerns: Level of Motivation10 being most motivated01020304050607080910 How Did You Hear About Us?Which MediaInternetFrom a FriendTelevisionOther Do You Have Extended Health Insurance?ChooseYesNo Contact Us Now Type of Treatment12 weeks weight loss programIdeal ProteinVelaShape3D Lipo LaserOther Do You Have Extended Health Insurance?YesNo What is 5 + 1?