Flex, Pay with HSA/FSA

Deep End Fitness

Total

$250.00

All items in your cart are HSA/FSA eligible!

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Contact

First Name

Last Name

Phone

Intake Form

A clinical team will review the data from your intake form to determine HSA/FSA eligibility in compliance with the IRS. We value your privacy and data is only used for this purpose.

State of Residence

Date Of Birth

Sex

Please share the condition(s) you are seeking treatment for

How long have you struggled with the condition?

A few weeks

A few months

>1 year

Have you been diagnosed with any of the following?

Heart Conditions

High Blood Pressure or Hypertension

Diabetes

Ashthma or COPD

None

Do you experience any of the following symptoms during or after physical activity?

Chest pain or discomfort

Faint or severe dizziness

None

Do you know of any other reason why you should not engage in physical activity?

Yes

What, if any, other treatment methods have you tried to treat your condition? Enter "N/A" if not applicable.

Do you have any other medical conditions or history of prior surgeries?

Yes

Are you currently taking any medications, vitamins, or supplements regularly?

Yes

Do you have any questions for our physicians before we proceed?

Yes

HSA/FSA Payment

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Deep End Fitness

Deep End Fitness Level 1

$250.00

Level 1 Price

Qty 1

HSA | FSA

Subtotal

$250.00

Total

$250.00

Contact

Intake Form

Cardiovascular Diseases

Metabolic Diseases

Respiratory Diseases

Musculoskeletal Diseases

Mental Health Conditions

Neurological Conditions

Gastrointestinal Conditions

Endocrine Disorders

Sleep Disorders

Chronic Pain Conditions

Postural and Balance Issues (falls and fractures in the elderly)

Pregnancy-Related Conditions

Aging-Related Conditions

Addiction Recovery

Inflammatory Conditions

HSA/FSA Payment