Is there one person you can think of who you would like to get checked by Dr. Zachary Ward at Life In Alignment?

Yes? That’s great! Below you’ll find a helpful form to make your referral as easy as possible.

Each month, we offer 12 complimentary screening opportunities to your referrals. This includes a 15 minute conversation, and an in depth overview of their posture and spinal balance from the unique perspective that our practice uses.

Your referral will

  • Learn something about him or herself they never knew
  • Have a relaxed and non-judgemental conversation about the health challenges they face
  • Learn whether they’re a candidate for care, and what kind of improvements they can expect

How to make the referral process as easy as possible

We understand that sometimes it feels really easy to refer. And sometimes it seems difficult even if you really want someone to get checked in our office.

Below you’ll find a short form that will help you refer someone you know right this moment.

  • Enter the information below
  • Your referral will get a short email sent to them automatically, with some information about our office, including information on how to request one of our complimentary screenings
  • Your referral will not be put onto a list, or be contacted by me or my office unless you request it

Referring Family and Friends

Ready to refer a family member or friend to my practice? Filling out this brief form will do it for you, automatically.

  • This will let your referral know that the information I send is coming from you.
  • You'll receive confirmation through your email, and a copy of the email we send to your friends/family.
  • Please enter the name of the family member or friend you are referring.
  • Please enter the most likely to be opened email address of the person you're referring to my practice. Please enter the address twice, to make sure that we're sending it to the right person.
  • This is optional. If you'd like me or my assistant to personally call and set up a consultation/screening with your referral, please enter their number below.
  • This is optional. If you've left a number, please let us know whether we should call to set up a consultation, or wait to have them contact the practice.
  • This is optional. If you'd like me or my assistant to send information about my practice to your referral, please enter their address below.
  • This is optional. Why are you recommending this person get their alignment checked? Please include any information you'd like to share with this person. It will be included with the email that get from me or my assistant. If we have personally worked together, this might be a good time to mention that, and list a few things you've like about the experience. Please keep in mind that most email providers are not HIPAA safe, and any personal health information provided here may not be protected.
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