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?  

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 6-12 months for individuals dealing with chronic health issues (having symptoms that have persisted longer than 6 months). If you are seeking care for a chronic health condition, are you willing to commit to this length of time?






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 for chronic health conditions include natural medicines which is an added out of pocket cost to you. These medicines can vary in price but it is important to understand that you will be asked to make a financial commitment to your health.  Please answer "yes" if you are able to financially prioritize your health at this time.  If your finances are an obstacle to seeking care, please answer "no". 





Question 11 of 13

Dr.Buttler does accept the following insurance companies Providence, BCBS, Pacific Source, MODA and HMA.( Dr.Buttler does not accept United, Cigna, HealthNet, AETNA, or Kaiser)

If you have one of the covered 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, we offer a time of service discount and payment will be due at the time of 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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