Our Home Natural Health Retreat — Application Form
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Our Home Natural Health Retreat
Health Guest Application & Questionnaire
480 Neely Lane  •  Huntingdon, TN 38344  •  731.244.2140  •  Fax 731.244.2241
[email protected]  •  [www.meetministry.org](https://www.meetministry.org)
For Your Information
Conditions of Acceptance

Our Home Natural Health Retreat is an educational lifestyle center where health guests are received as students and guided in implementing a program of health recovery. All educational information and program activities are based on a natural health model consistent with Biblical principles.

In order to provide a safe, supportive, and Christ-centered environment for all, each health guest must:

  • Be of legal age of accountability
  • Be physically mobile and able to perform one's own personal hygiene
  • Be mentally competent and capable of making their own decisions
  • Be emotionally stable and self-responsible
  • Be able to follow clearly written instructions
  • Be willing to cooperate with their unique program

To reserve a space and to be confirmed as a health guest, he/she must submit for review:

  • A completed Health Guest Application Form
  • Current medical and mental health records. Past records will be requested as indicated. Records may include any lab reports, CAT scans, x-rays, summaries, diagnosis, psychological assessments or other related records.
  • A non-refundable deposit of $700 upon acceptance with the remaining balance paid in full two weeks before your arrival.

The above submissions must be received prior to acceptance. Please note: We operate a small facility with limited space. Applications will be processed in the order in which they are received.

In consideration of MEET Ministry's decades of successful service, we continue to cooperate with God who is the true source of healing. We look forward to serving you.

Financial Information

The suggested donations for our programs are:

Program / Participant Suggested Donation
Standard Donation — 18-Day Cleansing Program
1 Person — full participant$6,045
2 Persons (Husband & Wife) — both participating$11,539
2 Persons (Husband & Wife) — only one participating$8,792
Standard Donation — 10-Day Cleansing Program
1 Person — full participant$3,520
2 Persons (Husband & Wife) — both participating$6,765
2 Persons (Husband & Wife) — one participating$5,143
Donation for Other Conditions* — 18-Day Cleansing Program
1 Person — full participant$6,595
2 Persons (Husband & Wife) — both participating$12,639
2 Persons (Husband & Wife) — both participating, 1 with other condition(s)*$12,089
2 Persons (Husband & Wife) — only one participating$9,617
Donation for Other Conditions* — 10-Day Cleansing Program
1 Person — full participant$4,070
2 Persons (Husband & Wife) — both participating$7,865
2 Persons (Husband & Wife) — both participating, 1 with other condition(s)*$7,315
2 Persons (Husband & Wife) — one participating$5,968

DEPOSIT: A minimum non-refundable deposit of $700 for all guests is required once your application has been approved to reserve your space.

BALANCE DUE: The remaining balance, which is due two weeks prior to arrival, is also non-refundable, except for uncontrollable circumstances.

*Other Conditions include, but are not limited to: Cancer, AIDS, HIV+, ALS, Multiple Sclerosis, etc.

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⚠️ Please scroll up and check the acknowledgment box on Page 1 to unlock this section
Health Guest Application & Questionnaire Form
I hereby state that I do not represent any food, drug, medical, or government organization. All information provided is true and complete to the best of my knowledge. I understand that this information will be used to develop my individual program of care.

1 · Personal Information
Emergency Contacts
Session Length
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2 · You Would Like Assistance With
3 · Personal Information
Tobacco / Smoking
Alcohol
Caffeinated Drinks
Energy & Activity
Screen Time & Sleep
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4 · Nutrition
Regular American Diet
Other Diet Patterns
Do You Regularly Partake Of:
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5 · Allergies
Medication
Food
Other
6 · Medications & Supplements
7 · Medication History
Category No Yes Type / when / how long
8 · Devices
DeviceNoYesDeviceNoYes
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9 · Surgery History
Organ / Area No Yes When? Organ / Area No Yes When?
Women
Men
10 · Radiation Procedures
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11 · Family Health History
12 · Review of Body Systems — Current Symptoms
Cardiovascular
Digestive
Musculoskeletal
Neurological
Skin
General
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13 · Mental & Emotional Health
14 · Additional Information
15 · Physician / Healthcare Provider
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16 · Consent & Authorization
I understand that Our Home Natural Health Retreat is an educational lifestyle center, not a medical facility. Staff members are not licensed medical doctors and nothing provided constitutes medical diagnosis or treatment. I take full responsibility for all health decisions I make while in attendance. I understand the program is based on natural health principles consistent with Biblical teachings.

By signing below, I affirm that all information provided in this application is true and complete to the best of my knowledge. I agree to abide by the rules and guidelines of Our Home Natural Health Retreat. I understand that failure to disclose significant health information, or failure to comply with program guidelines, may result in discharge from the program. I release MEET Ministry and its staff from liability for any consequences arising from information I have withheld or misrepresented.


Guardian / Authorized Representative (if guest is a minor or unable to sign)

Thank you for completing this application.
Questions? Call (731) 244-2140  |  Fax (731) 244-2241  |  [email protected]
Tip: Click Save as PDF to keep a personal copy of your completed form — then click Submit Application when ready.