One on One
Counseling Application

If you're ready to work with me one on one, fill out the form below.

If you are a Mensah Medical patient, click here.

Please read my frequently asked questions before filling out this form.

Your information is secure and confidential. I do not share
with third-parties.

I work in four and eight month increments at a rate of $179 per month. I only work via phone (in the US) and Skype (if outside the US).

Please check spam folders if you do not receive a response. We strongly recommend using a free GMail account to avoid high level spam blockers.

Full Name

What is your age?

E-Mail Address

What is your mobile number?

In what part of the world do you live? (city, state, country)

Are you a Mensah Medical patient?

What challenges will keep you from committing to a daily dietary and supplemental regimen?

Briefly describe the top 3 health challenges you're currently facing?

Briefly describe what you want to achieve by working with Sami?