Retail Account Request

RETAIL SERVICES

If you are a practitioner who doesn't wish to open a wholesale account with us but still desires our services on a case by case basis, we are happy to assist you through our retail menu of services.

If you are not a licensed or certifed practitioner we reserve the right to pair you with one of our trained practitioners before agreeing to providing services to you. Consultation charges will be determined by the practitioner whom we refer you to in addition to any energetic assessments ordered.

Please Disclaimer read our disclaimer in full and understand clearly that bioenergetic assessments are not meant to diagnose or prescribe and never replace the advice of a licensed medical provider. BioEnergetic Assessments fall under the category of complimentary and alternative health. * - Indicates this is a retail specific cost.

RETAIL SERVICES ACCOUNT REQUEST: Please only use this form if you need RETAIL services.
For practitioners needing wholesale services please go to Join Us Here

* Indicates required field

Name *

First

Last

City, State, Zip *

Email *

Phone Number *

I am: *

A Professional in need of services or consultation on a case by case basis. An Individual in need of services and I ALREADY have a wellness practitioner. An Individual in need of services and I NEED a wellness practitioner.

Inquiring Retail Clients please proceed to. Client Initial Intake/ Consent after completing this contact form. We will be in touch within 72 business hours.

Disclaimer (CLICK BLUE LINK TO READ IN FULL)

I certify I have read the DISCLAIMER and I release BAR, LLC and its affiliates, members, owners, and agents of all liablity for services through this website. *

Yes

Type your FULL NAME in the box below. This will serve as your electronic signature and agreement to terms of service and confirmation you have read and understand the disclaimer *

Submit

RETAIL SERVICES

RETAIL SERVICES ACCOUNT REQUEST: Please only use this form if you need RETAIL services.​For practitioners needing wholesale services please go to Join Us Here

Inquiring Retail Clients please proceed to. Client Initial Intake/ Consent after completing this contact form. We will be in touch within 72 business hours.

​​Disclaimer (CLICK BLUE LINK TO READ IN FULL)

RETAIL SERVICES ACCOUNT REQUEST: Please only use this form if you need RETAIL services.
For practitioners needing wholesale services please go to Join Us Here

Disclaimer (CLICK BLUE LINK TO READ IN FULL)