Home
Method
About
Coaching
Client Testimonials
Contact
Menu
Home
Method
About
Coaching
Client Testimonials
Contact
REGISTRATION FORM
First Name
Last Name
Email
Cell Phone
Address
City
State
How did you hear about us?
Medical conditions, Injuries, personal notes
You can attach a photo for energy diagnostics or other information
I understand that Alex Akselrod is a wellness coach dedicated to sharing his knowledge, tools and resources with clients. His services are meant to be support in addition to any other medical treatments necessary. Wellness coaches do not diagnose conditions, nor do they prescribe or perform medical treatment, prescribe substances, nor interfere with the treatment of a doctor. I understand that wellness coaching does not take the place of medical care. It is recommended that I see a physician for any physical or psychological ailment I may have.
E-Signature (Full Name)
Date
SUBMIT
Referral Program
Registration Form
Resources
Stress Management
Contact Us
+1 860-980-0857
Bellevue, Washington
Google
Facebook
Twitter
OPENING HOURS
Monday - Friday:
9:00AM - 8:00PM
Saturday - Sunday:
9:00AM - 8:00PM
SUBSCRIBE TO NEWSLETTER
Receive exclusive email offers and promotions.
Email
Submit