Step 1 of 2 - Cancer Freedom Program Application
with Dr. Amy, Cancer Expert - Cancer Survivor
settings
First Name
settings
Last Name
settings
Email
settings
Office Phone
settings
Select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
D.C.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Mexico
New Jersey
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
(AU) Australian Capital Territory
(AU) New South Wales
(AU) Victoria
(AU) Queensland
(AU) Northern Territory
(AU) Western Australia
(AU) South Australia
(AU) Tasmania
(ZA) Gauteng
(ZA) Western Cape
(ZA) Eastern Cape
(ZA) KwaZulu Natal
(ZA) North West
(ZA) Northern Cape
(ZA) Mpumalanga
(ZA) Free State
My State is not listed
What is the state or province you live in?
settings
What is your biggest cancer related struggle right now?
settings
Select...
Yes
No
Are you currently receiving IV Chemotherapy or Radiation?
settings
Select...
I am fully committed! I have the finances and I am committed to making this happen.
I am committed. I can get the finances and want to make this happen.
I am pretty committed, but I'm not really sure I'm ready to prioritize my recovery yet.
I am not committed at all.
Knowing that recovering from cancer and achieving your goals requires both a financial and time investment, how committed are you to achieving your goals? NOTE: My 8 week program cost is 2 payments of $1,800 USD or a one time payment of $3,200 USD
settings
Select...
This week
Next month
Next year
Never
If we had a solution that had everything you were looking for, would that be something you'd want to move forward with...
settings
Select...
Yes
No
Are you willing to put in the effort to see the application process through?
settings
Apply Now
Step 1 of 2 - Cancer Freedom Program Application
with Dr. Amy, Cancer Expert - Cancer Survivor
settings
First Name
settings
Last Name
settings
Email
settings
Office Phone
settings
Select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
D.C.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Mexico
New Jersey
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
(AU) Australian Capital Territory
(AU) New South Wales
(AU) Victoria
(AU) Queensland
(AU) Northern Territory
(AU) Western Australia
(AU) South Australia
(AU) Tasmania
(ZA) Gauteng
(ZA) Western Cape
(ZA) Eastern Cape
(ZA) KwaZulu Natal
(ZA) North West
(ZA) Northern Cape
(ZA) Mpumalanga
(ZA) Free State
My State is not listed
What is the state or province you live in?
settings
What is your biggest cancer related struggle right now?
settings
Select...
Yes
No
Are you currently receiving IV Chemotherapy or Radiation?
settings
Select...
I am fully committed! I have the finances and I am committed to making this happen.
I am committed. I can get the finances and want to make this happen.
I am pretty committed, but I'm not really sure I'm ready to prioritize my recovery yet.
I am not committed at all.
Knowing that recovering from cancer and achieving your goals requires both a financial and time investment, how committed are you to achieving your goals? NOTE: My 8 week program cost is 2 payments of $1,800 USD or a one time payment of $3,200 USD
settings
Select...
This week
Next month
Next year
Never
If we had a solution that had everything you were looking for, would that be something you'd want to move forward with...
settings
Select...
Yes
No
Are you willing to put in the effort to see the application process through?
settings
Apply Now
noScriptSubmitBtn
[bot_catcher]