In-Depth Wellness Consultation

After completing the form below you'll be directed to checkout

Please complete this form for one individual at a time. The name, date of birth, contact information, and other personal details must belong to the person having their results reviewed and receiving the consultation.

If ordering a consultation for multiple individuals, please submit a separate form using each person’s unique information and make a separate payment. Do not use the same email address for multiple individuals.

Important Notes:

1). Please ensure that the lab results you're uploading are from labs that have been drawn within the past 90 days.

2). This service is only available to customers located in the United States.

First Name *

Last Name *

Phone *

Email *

Date of birth *

Gender *

Female

Male

Address

Street Address

Country *

State *

City *

Postal Code *

Please use the first document upload field below to provide your recent bloodwork lab results. If you have additional test results you'd like our team to review alongside your bloodwork such as a GI-MAP or DNA test you may upload that file in the second document upload field below. (*providing a second document is optiFile Uploadonal.)

Upload Your Recent Bloodwork Lab Results *

Click to upload

Please ensure the labs you're uploading have been pulled within the last 90-days.

Additional Lab Documents

Click to upload

Authorization to access lab results and patient portal

I acknowledge and authorize Fullscript to disclose to Rooted Coaching, LLC the following: results of laboratory bloodwork and related lab reports ordered in connection with my participation in consultations and/or coaching services, Purpose: At my request, to support my wellness. This authorization expires upon the end of my services engagement with Rooted Coaching, LLC. I understand that: (1) I may revoke this authorization at any time in writing to [email protected], except where action has already been taken in reliance on it; (2) the clinic may not condition treatment or payment on my signing it; and (3) information disclosed under this authorization may be redisclosed by Rooted Coaching, LLC and may no longer be protected byHIPAA. - I have read and understand the labs liability waiver.

Lab & Patient Portal Authorization Signature *

Clear

I have read and understand the Authorization to Access Lab Results and Patient Portal, as well as the Labs Liability Waiver, and I consent to Advanced Vitality and Move with Modus accessing my lab results and patient portal information as described above. *

Yes

I consent to receive infrequent SMS notifications from Rooted Coaching, LLC. Mobile carrier message & data rates may apply. I acknowledge I can reply STOP at any time to unsubscribe or HELP to receive assistance.

A Note From Our Founder

Kaycee Hines

I want people to feel GOOD in their bodies. Not just look a certain way, but actually have the energy, strength, and confidence to enjoy their lives. So many of the people I work with have already tried the extreme plans and the typical "just eat less and move more" advice, and quite honestly, they're over it.

Rooted Coaching is about doing things differently. We build a plan around YOU, your goals, your history, your bloodwork, and the season of life you're in. Because at the end of the day, your health should help you show up BETTER for the people and things you love, not take away from them.