Welcome to WholeBodySupport.com
Due to the ever-changing world of alternative and natural medicine we are required to have a brief medical history on all of our patients/customers.  We apologize for your inconvenience for the brief time it takes to complete this one-time questionnaire. Also, please be aware that our products are for personal consumption only, no resellers please.

We look forward to serving your health supplement needs.
What is your first name? *

What is your last name? *

What is the best phone number to reach you at? *

What address do you want us to ship to?

Street address? *

Apartment number or suite number?

City? *

State? *

Zip Code? *

Shipping to the U.S. correct? *

Great {{answer_57238688}}, now we can ship supplements right to your door! Next we are going to ask a few health related questions to be able to best serve you.

What is your gender? *

What is your age? *

Do you have a primary doctor advising you on supplement choices? *

What is your primary doctors name? *

What is the address of your doctor? *

If you don't have a primary doctor advising you on your supplements we require a FREE 5 Minute consultation with our doctor. At the end of this questionnaire we will provide our business hours and phone number to reach our doctor.

Briefly describe any symptoms or conditions: *

We want to make sure our supplements are best suited for your health goals. Any information here would truly help us understand the best approach to your care.
Do you have any allergies? *

Thanks {{answer_57238688}}! We look forward to serving you with the best natural and homeopathic supplements available online. Please continue to the next screen to confirm your account. If you do not have a primary physician, our business hours and the phone number to call for your one-time 5 minute consultation will also be provided.

Your account is now in our system {{answer_57238688}}. We will send your login information shortly after reviewing your answers.

Please call us at (231) 421-5213 for your FREE 5 minute consultation.
Our Business Hours:
Monday-Thursday 12pm to 6pm EST
Friday 9am to 3pm EST
To WholeBodySupport.com
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