Comprehensive consultation

$599 Bloodwork & lab review

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 blood drawn 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.

First Name *

Last Name *

Email *

Mobile Phone *

Date of Birth *

Gender *

Address

Street Address

City

State

Country

Postal (zip) code

Which lab partner will you be using?

Labcorp

Quest Diagnostics

Authorization to access lab results and patient portal

I acknowledge and authorize Advanced Vitality HRT (3805 Edwards Rd, Suite 100Cincinnati, OH 45209) to disclose to New Vision Strength and Nutrition LLC DBA Move with Modus (700 Stonecrest Drive New Holland, PA 17557) 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 Move with Modus. 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 Move with Modus and may no longer be protected by HIPAA. - I have read and understand the labs liability waiver.

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.

*

Modus coaches are not licensed physicians, registered dietitians, or medical professionals. Modus services do not involve the rendering of medical advice, diagnosis, or treatment. Any data shared by a client is used solely for general educational and behavioral accountability purposes only. All findings require review by your ordering physician before clinical action is taken. Modus services are not a substitute for medical advice, diagnosis, or treatment.

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

Privacy Policy | Terms of Service | Labs Liability Waiver

COMPREHESIVE LABS

what we test

Our Female Panel

Estradiol
Progesterone
Testosterone (Free & Total)
FSH & LH
DHEA-Sulfate
Vitamin D 25-Hydroxy
Cortisol
Reverse T3
TSH, T4 Free, T3 Free
Thyroid Peroxidase (TPO) Antibodies
Comprehensive Metabolic Panel (CMP-14)
CBC with Differential/Platelet
Lipid Panel
C-Reactive Protein (hs-CRP)
Hemoglobin A1c
Insulin
Iron
Sex Hormone Binding Globulin (SHBG)
Ferritin
Vitamin b12
ApoB

Our Male Panel

Estradiol
Testosterone (Free & Total)
FSH & LH
Vitamin D 25-Hydroxy
Cortisol
Reverse T3
TSH, T4 Free, T3 Free
Thyroid Peroxidase (TPO) Antibodies
Comprehensive Metabolic Panel (CMP-14)
CBC with Differential/Platelet
Lipid Panel
C-Reactive Protein (hs-CRP)
Hemoglobin A1c
Insulin
GGT
PSA (Prostate-Specific Antigen)
SHBG
Iron
Ferritin
Vitamin b12
ApoB

real solutions to your biggest challenges

how can modus help you?

weight loss

optimize nutrition

muscle mass

lower inflamation

injury recovery

building muscle

improve libido

improve sleep

heart health

restore gut health

increase energy

Leading Well

client transformations

real clients. real results.