

Vitality & Longevity Consultation Intake Form
At Benton Integrative Medicine, we believe health is more than the absence of disease — it’s the presence of vitality, clarity, resilience, and strength.
Our Vitality & Longevity consultations are designed for individuals who want to take a proactive, personalized approach to their health. Whether you’re interested in optimizing energy, improving recovery, supporting metabolic health, exploring peptide therapies, or learning about emerging longevity strategies, our goal is to help you better understand your body and create a plan that supports long-term wellness.
Sara, our Nurse Practitioner specializing in vitality and longevity medicine, leads this area of care at Benton Integrative. Her approach combines evidence-informed medicine with cutting-edge tools in preventative health, including lifestyle optimization, metabolic health strategies, and educational guidance around therapies such as peptides and regenerative approaches.
This intake form helps our team understand your goals, current health status, and areas you’d like to improve so we can prepare thoughtfully for your consultation. Together, we’ll explore ways to support your body’s natural capacity for repair, performance, and long-term vitality.
Please complete the form below to begin. Our team will review your responses and reach out to help schedule your consultation. We look forward to partnering with you in your health journey.
