New Patient Enrollment

Begin Your Journey to Cognitive Clarity & Peak Performance

Submit the secure form below to start your enrollment. We'll review your information and guide you through scheduling your $250 Comprehensive Health Assessment with Dr. Foroutan.

How Enrollment Works

  1. Submit Your Information: Complete the enrollment form below with your contact details, location, and health goals.
  2. Eligibility Review: We'll review your submission within 24-48 hours to confirm we're licensed to serve you in Florida, Virginia, or Maryland.
  3. Schedule Your Health Assessment: Upon acceptance, you'll receive a secure link to pay the $250 Comprehensive Health Assessment fee and schedule your comprehensive intake appointment with Dr. Foroutan.
  4. Choose Your Tier: During or after your Health Audit, select the membership tier (Foundation, Synergy, or Executive) that aligns with your performance goals.

Questions before enrolling? Contact us — we're here to help you determine if Bonsai Health is the right fit.