Divine Health Group

Divine Health GroupDivine Health GroupDivine Health Group
  • Home
  • Weight loss Medications
  • Peptides and Vitamins
  • Jesus Shot
  • IV Therapy
  • Ketamine Treatment
  • DHG Medication Kit
  • Ivermectin
  • Weight Loss Support
    • Navigating Weight Loss
    • Meet Our Dietitian
  • Pay Options
  • Acute Appointments
  • Mental Health
  • For Providers
  • Students
  • Forms
    • Forms
  • Substance Use Disorder
  • Genetic Testing
  • Meet Our Staff
  • More
    • Home
    • Weight loss Medications
    • Peptides and Vitamins
    • Jesus Shot
    • IV Therapy
    • Ketamine Treatment
    • DHG Medication Kit
    • Ivermectin
    • Weight Loss Support
      • Navigating Weight Loss
      • Meet Our Dietitian
    • Pay Options
    • Acute Appointments
    • Mental Health
    • For Providers
    • Students
    • Forms
      • Forms
    • Substance Use Disorder
    • Genetic Testing
    • Meet Our Staff

Divine Health Group

Divine Health GroupDivine Health GroupDivine Health Group
  • Home
  • Weight loss Medications
  • Peptides and Vitamins
  • Jesus Shot
  • IV Therapy
  • Ketamine Treatment
  • DHG Medication Kit
  • Ivermectin
  • Weight Loss Support
    • Navigating Weight Loss
    • Meet Our Dietitian
  • Pay Options
  • Acute Appointments
  • Mental Health
  • For Providers
  • Students
  • Forms
    • Forms
  • Substance Use Disorder
  • Genetic Testing
  • Meet Our Staff

Forms

Acute Treatment Symptoms Check list (pdf)Download
Chronic Pain History (pdf)Download
Consent for Acute TX (pdf)Download
Consent for Medication (pdf)Download
Consent for Weight loss TX (pdf)Download
Consent to Treat and Acknowledgement Form (pdf)Download
Initial History Form (pdf)Download
Informed consent for peptide therapy (docx)Download
Informed consent for anti-aging (docx)Download
Initial Form (pdf)Download
Jesus Shot History Form (pdf)Download
ROI Divine (pdf)Download
Ketamine Troche Disclosure and Consent (pdf)Download
IV Vitamin Supplement Consent Form (pdf)Download
Ivermectin Consent (pdf)Download
Jesus Shot consent (pdf)Download
Medication Kit Consent (pdf)Download
Sliding fee scale application 2025 (pdf)Download

No one will be denied access to services due to inability to pay. Additionally, a discounted/sliding fee schedule is available based on family size and income for necessary or medical s.  


This site does not discriminate in the provision of services to an individual who is unable to pay; because payment for those services would be made under Medicare, Medicaid, or the Children's Health Insurance Program (CHIP); or based upon the individual's race, color, sex, national origin, disability, religion, age, sexual orientation, or gender identity. 

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  • Acute Appointments
  • Mental Health
  • Meet Our Staff

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