Ready to Take Control of Your Health?

You’re about to take the first step to a healthier you! At TM360 MedSpa, we provide a wide range of non-invasive cosmetic procedures and spa services – all to promote that important balance between body, mind, and spirit. By taking this quick test, you’re providing us with preliminary details about you and your particular health concern; we can then use this information to customize your TM360 MedSpaexperience and determine which natural, holistic remedy is right for you.

Get started now by answering the following questions. Once you submit your responses, a TM360 MedSparepresentative will contact you as soon as possible.

 


About Your Health

1. How healthy do you consider yourself?

Please answer how healthy you consider yourself.

2. Would you like to lose weight?

Please answer would you like to lose weight.

How much would you like to lose?
Please answer how much weight would you like to lose?

3. Are you looking for pain relief?

Please answer where you are looking for pain relief.

Where are you trying to relieve pain?
Please answer where you are trying to relieve pain?

4. Which of these symptoms are you experiencing? (Check all that apply)

Please answer which of these symptoms are you experiencing.

5. What aspects of your skin would you like to improve? (Check all that apply)

Please answer what aspects of your skin would you like to improve.

6. Which of the following aesthetic treatments have you had? (Check all that apply)

Please answer what aspects of your skin would you like to improve.

Please explain.
Please explain.

7. Which of the following services are you interested in learning more about? (Check all that apply)

Please answer which of the following services are you interested in learning more about

Please explain.
Please explain.

About You

8. Which term best describes your gender identity?

Please answer which term best describes your gender identity.

Please provide your preferred term.
Please provide your preferred term.

9. What is your age?

Please provide your age.

Your Contact Information

We’ll use the contact information you provide here to follow up with you with your health test results. We respect your privacy and never give your contact details to third parties as per our privacy policy.

First Name
Please enter your first name.

Last Name
Please enter your last name.

Email
Please enter a valid email address.

Phone
Please enter a valid phone number (123-456-7890).

Anything else you want to let us know? (Optional)
Anything else you want to let us know?

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