Peak Human New Patient Inquiry

Thank you for showing interest in working with Peak Human! Before we start on your journey, please fill our inquiry form below to give us an idea of how we can best support you.

First Name

Last Name

Phone

Address

Date of Birth

How did you hear about Peak Human?

Profession

Do you have insurance coverage for one or more of the following services (check all that apply)?

Chiropractic Naturopathy Holistic Nutrition Massage Therapy

Were there any specific tests/treatments you were interested in from our clinic?

Anything else you would like us to know?

Dr. Sanjeev Goel is the lead physician at Kennedy medical centre for past 20+ years in Brampton, founder of Peak Human anti-aging, and regenerative medicine practice, and founder of Spark Medical Cannabis clinics.

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DISCLAIMER: Statements on this website have not been evaluated by the US FDA. These products and their statements are not intended to diagnose, treat, cure, or prevent any disease. If you are taking prescription medication, have a medical condition or are pregnant or nursing, consult your physician prior to use. Not for children. Results may vary.