Wellness Clinic Intake Form

Welcome to The Church Of Ubuntu Wellness Clinic Intake Form

Thank you for your payment.

First, please complete our wellness intake form below, with as much information as possible. If you or your carer are unable to complete this form for either health reasons, or internet limitations, please email info@churchofubuntu.org or call 02 4926 1881 between 10am to 6pm Monday to Friday.

Once your wellness form is received and entered into our system our consultants read all your case particulars and create a comprehensive program for you including, diet, health, lifestyle, natural medicine recommendations and where to purchase medicines. You will then receive a personal phone call (and email) from one of our assistants, containing all of this information and how you can proceed. (first contact generally takes about 7 to 14 days from intake form receipt, assessment within 21 days pending our workload, with apologies). If you have any questions about the time and process please contact us.

Terms and conditions refund and returns policy

PLEASE NOTE:

*Please ensure ALL answer fields are filled in, where a question is not relevant please type N/A
*Please also correct any error messages prior to resubmitting
*Please regularly check your 'junk box', or similar, for emails from us

Thankyou
team UBUNTU

The Church of Ubuntu is supported by many members of the community, we are a not for profit incorporated association. Our health consultants are all highly experienced and each one can offer a great insight into your health and well-being . The first step to wellness is to accept full responsibility for ones own health, we offer a much needed alternative to allopathic medicines, we aim to cure occasionally, relieve often, and comfort always. The Ubuntu Team.

Once the form is completed you will be redirected to our intake form support information page. It is important that you watch the video and read and understand the nutritional guidelines available on this page before your consultation.

Intake Form