Call us for any question

Get Started with YOur Session Application

1 Geeting Started

2 Personal Info

3 Program Info

4 Health Concerns

Getting started is simple. This application can take you 7 – 15 minutes to complete.

Eden Lifestyle Home Health & Lifestyle Center by Eden Lifestyle, Inc.,as indicated in our
terms and disclaimer, is an educational and faith-based healing organization where guests come to learn to
maintain or recover their health and take charge of their own lives. We are not a medical facility, nor do we
give medical advice.
*
- Yes, I understand and accept these terms.

First name*
Last name*
Best E-Mail*
Phone Number*
Date of Birth*
Sex*
Address*
State/Province*
Street*
City*
Country*
Postal Code*
Nationality*

What are your reasons and expectations for coming to Eden Lifestyle Home?
Will you be bringing a companion guest?*
- Yes
- No
Select Your program*
I/we wish to attend your lifestyle session*
*A companion guest is someone that will accompany and stay with you
for the duration of your health session. Companion guests will not be
involved in any therapies but will assist anywhere possible.

List your health concerns*
Are you able to shower on your own?*
Are you able to use the restroom on your own?*
Are you able to eat and drink on your own?*
Are you challenged with mobility issues (standing, sitting, lying down)?*
Do you use an aid to walk?*
Are you mentally competent and capable of making your own decisions?*
Are you emotionally stable and self-responsible?*
Are you able to follow clear written instructions?*

Copyright © 2020 Eden Lifestyle Home by Eden Lifestyle Ministry, Inc. All Rights Reserved.

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Eden Lifestyle home by Eden Lifestyle Ministry is an educational & biblical healing ministry where guests come to learn to maintain or recover their health
and take charge of their own lives. We are not a medical facility or treatment center, nor do we give medical advice. The information provided in this
website is designed for educational purposes only and reflects the Biblical life-style designed by God for our health and happiness. The information
presented herein is not to be used as medical advice or to diagnose or treat disease. For diagnosis, treatment or any other procedures including allopathic
medical advice, see your healthcare professional . For healing, see the Great Physician. (Psalm 103:1-3, Exodus 15:26).

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