Congratulations for making the decision on my eCoaching program!


Let’s get started. I need you to gather and send the following information.

Information Needed:

  • recent lab work (just whatever you have on hand, no need to get anything extra until I write you back)
  • historical timeline of symptoms
  • treatments you have done, along with best results/worst results
  • your current doctor(s)- this information is also useful
  • Intake form – sign and send back.

Please Email

The form MUST BE SIGNED, so please sign it and either fax or scan it as a JPEG or PDF and attach it to an email. For those who can’t do either, you can always mail it to me. Just ask for the address and I’ll send it to you.

Once I get your information, review it and process it, I’ll send you an email about first things that need to happen.

And then…..we go from there!

I look forward to helping you get healthy!

All my best,

Perry Louis Fields