Prospective Patient Application to Work 1:1 with Dr. Buttler

Want to find out if my approach is right for you?

Fill out this brief application and my team will be in touch!

Can't wait to meet you!

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Question 1 of 13

Name (First, Last)

Question 2 of 13

Complete Address (Street, City, State, and Zip Code)

Question 3 of 13

Best Contact Phone

Question 4 of 13

Best Email Address

Question 5 of 13

Date of Birth

Question 6 of 13

How did you hear about Dr. Buttler?

Question 7 of 13

Please list what you are looking to address in your health with Dr. Buttler? (Note: Dr.Buttler is not a primary care physician and is not accepting any patients at this time for primary care)  

Question 8 of 13

 Dr Buttler uses a system of medicine to treat the underlying cause of dis-ease.  His focus is not on treating your symptoms. His method of treatment works not only on addressing the disease of the body but also the disease of the mind. Dr.Buttler will ask you to make lifestyle changes in your nutrition, movement and daily habits. Is this the type of care you are looking for?  





Question 9 of 13

Dr.Buttler's care is typically done over 12 months for individuals dealing with chronic health issues. Are you willing to fully commit to this time period of care?






Question 10 of 13

Your health is an investment that has the potential to save you thousands of dollars in future medical bills! Dr.Buttler's treatment plans include natural medicines which is an added out of pocket cost to you. These medicines can cost around $600-$700 initially to start and $500-$600 per month during your ongoing treatment plan.  Please answer yes if you understand this financial commit to your health.  If this is something you are not able to financially prioritize at this time please answer no. 





Question 11 of 13

Dr.Buttler does accept the following insurance companies Providence, BCBS, Pacific Source, MODA and HMA. If you have one of these insurance companies, please list which one and provide your ID number and group number. This is not a guarantee of coverage. Check your policy to see if you have naturopathic coverage. If you are not using insurance, payment will be due at the time to service. 

Question 12 of 13

Everything Dr.Buttler does is about moving you towards your vision of health. He has seen miracles happen when people have been left hopeless with no path to healing. What is your vision of what you want your health to look like? 



Question 13 of 13

For fun, if you could have dinner with 2 people (not family) alive or dead, who would they be?

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