Divine Health Group

Divine Health GroupDivine Health GroupDivine Health Group
  • Home
  • Jesus Shot
  • Weight Loss and Support
    • Medication Refills
    • Supplements
    • Navigating Weight Loss
    • Meet Our Dietitian
  • Peptides
  • Acute Appointments
  • Treatments & Services
  • Mental Health
  • For Providers
  • Students
  • Forms
    • Forms
  • Meet Our Staff
  • More
    • Home
    • Jesus Shot
    • Weight Loss and Support
      • Medication Refills
      • Supplements
      • Navigating Weight Loss
      • Meet Our Dietitian
    • Peptides
    • Acute Appointments
    • Treatments & Services
    • Mental Health
    • For Providers
    • Students
    • Forms
      • Forms
    • Meet Our Staff

Divine Health Group

Divine Health GroupDivine Health GroupDivine Health Group
  • Home
  • Jesus Shot
  • Weight Loss and Support
    • Medication Refills
    • Supplements
    • Navigating Weight Loss
    • Meet Our Dietitian
  • Peptides
  • Acute Appointments
  • Treatments & Services
  • Mental Health
  • For Providers
  • Students
  • Forms
    • Forms
  • 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

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.  


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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  • Jesus Shot
  • Medication Refills
  • Peptides
  • Acute Appointments
  • Treatments & Services
  • Mental Health
  • Genetic Testing
  • Meet Our Staff

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