PROGRAMS

2025 Core Restore 14 Day Detox Registration

First name

Last name

Birthday

Email

Phone

Are you a current patient of Buckhead Functional Medicine?

Yes

No

Do you have any existing medical conditions?

Yes. If yes please explain below.

No

If yes, list medical conditions.

Are you currently taking any medications?

Yes. If yes please explain below.

No

If yes, please list medications.

Do you have any allergies?

Yes. If yes please explain below.

No

If yes, please list allergies.

Have you participated in our detox program before?

Yes

No

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2025 Core Restore Detox Program

(678) 428-1653

Call

PROUD MEMBER OF

Location

3193 Howell Mill Rd NW #316,

Atlanta, GA 30327, USA

Fax: (404) 228-7135,

Phone:

(678) 428-1653

BOOK APPOINTMENT

New Users Register and use ID#18080

NUTRITIONAL FRONTIERS

ACCESS YOUR DISPENSARY

Medical Information Disclaimer: The health-related information on the astrewellness.com website is meant for basic informational purposes only. It is not intended to serve as medical advice, substitute for a doctor’s appointment or to be used for diagnosing or treating a disease. Users of this website are advised to consult with their physician before making any decisions concerning their health.

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