REBOOT YOUR BRAIN.

  • Step 1: Answer the following questions and submit.
  • Step 2: Pick a time on the embedded calendar (this will be available after you submit the questionnaire) for your Complimentary BrainReboot Strategy Session. Please commit to this time.
  • Step 3: During the Strategy Session, we will discuss your neurological challenges and goals, and we’ll give you a primer on the BrainReboot Program and if we believe that you are a good candidate for the Program. If so, we’ll guide you though the next steps.

"*" indicates required fields

PART I

First Name & First Initial of Last Name*
Please list up to three brain/neurological health concern(s), in order of importance. These can include symptoms, diagnoses, or a general goal of optimizing brain function:*

PART II

Please pick the most appropriate number for the next few questions. (0 = none/rarely, and 3 = multiple/often):

PART III