Page 1 of 2

Private Access Request

Attune is currently transitioning into a licensed, state-regulated structure. During this process, access is limited to select individuals aligned with our evolving offerings. Please complete this brief intake form so we can better understand your background and ensure a safe, intentional experience. Responses are 100% confidential and all data is protected.

Have you previously accessed Attune?

What are you currently seeking support with?

Have you ever used any natural or functional approaches for mood or cognitive support?

Are you currently taking any prescription medications for mental or emotional well-being?

How did you hear about Attune?

Why are you reaching out at this time?

Age verification

I confirm I am over 21 and am submitting this form voluntarily for access consideration.

Your information is confidential, used solely for intake consideration, and will never be shared or sold.