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Application for 20-Minute Free Discovery Call

Incorporating the latest advances in science, functional medicine affords a completely new way to view chronic wellness issues from dyslipidemia to diabetes, allergies to autoimmune disease, anxiety to autism and more.

Chronic disorders (and even lack of energy) are the result of physiological imbalances throughout your body – from systemic inflammation, insulin resistance, oxidative stress, to hormonal imbalances – made worse by poor diet or undiagnosed food sensitivities, lack of key nutrients, stress, emotional and environmental toxins, as well as a sedentary lifestyle:

What's your first name? *

What's your last name? *

What's your best phone number? *

What's your best email? *

Do you live in Montana or Wyoming? *

Are you a current patient of Montana Psychiatry? If yes, who is your psychiatric provider? *

How did you hear about Mood Restoration Institute? *

What are your top health concerns that you would like us to help you overcome? *

Why is resolving your health issues important to you and what do you think is stopping you from accomplishing this? *

Do you consider yourself coachable? *

Do you have a supportive spouse, significant other, or friend to support your personal goals? *

Who else have you worked with? *

Functional Medicine Practitioner
Medical Doctor/Osteopathic Doctor
Medical Specialist
Naturopathic Doctor
Traditional Chinese Medicine
Nutritionist/Dietician
Personal Trainer
Chiropractor
Personal Development Coach
Other:

What functional lab testing have you done previously? *

Functional Stool Testing
Organic Acids Testing
Adrenal/Cortisol Testing
Genetic or Genomic Testing
Hormone Testing
Food Sensitivity Testing
Heavy Metal Testing
None
Other:

Considering your past treatments, what would you like to improve or do differently moving forward? *

Are you willing to do what's necessary to reclaim your health? (This may include dietary modifications, functional lab testing, lifestyle and environmental modifications, etc) *

If we can find a root cause solution to help you restore your health, are you willing to invest in services, supplements, and testing that may not be covered by health insurance? *

Yes, I am ready & able to invest in my health now.
No, I'm not able to at this time. I have other priorities.

I understand Mood Restoration Institute is not contracted with any health insurance company. *

Yes, I understand that Mood Restoration Institute is not contracted with any health insurance company.
Unfortunately, I need a program that will take my health insurance for all services.

If you are NOT the sole financial decision maker please confirm your spouse, significant other, or parent(s), etc. will be on the Discovery Call with you: *

Yes, I will have them on the phone call with you.
No, I can't have them on the call with you.

In your opinion, what makes you a good fit for our program? *

Contact Us

3737 Grand Avenue, Suite 4
Billings, MT 59102
Phone: 406.670.1498
Email : info@moodrestorationinstitute.com

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Book A Free Discovery Call

Application for 20-Minute Free Discovery Call

Contact Us

Quick Links

Focus Areas

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