AI Wellness

VIP Concierge Form

AI Wellness VIP Concierge Intake

[F1 LAS VEGAS WEEKENDER]
VIP Concierge Experience Registration

Physician-Guided Concierge-Level Experience Curated Guest List Personalized Healthspan Roadmap Priority Scheduling

Welcome to Your Personalized Healthspan Journey

Congratulations! You have been selected as one of our curated guests for the Physician & VIP Experience Registration

To provide every guest with a seamless physician-guided, concierge-level experience, all attendees must complete this VIP Concierge Intake before arrival.

Because this is a highly curated event with limited physician appointments, wellness experiences, and VIP capacity, completion of this intake is required before your VIP access can be issued.

Your responses allow our Concierge Team to:

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Confirm your attendance

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Build your customized wellness itinerary

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Reserve physician consultations and wellness experiences

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Coordinate concierge scheduling

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Recommend experiences based on your goals

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Prepare your personalized Healthspan Roadmap

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Prioritize guests who reserve experiences before arrival

Prepaid and confirmed guests receive priority scheduling, expedited check-in, and concierge planning.
VIP Concierge

Guest Information

Name
Name
First Name
Last Name
Address
Address
City
State/Province
Zip/Postal
Country
Referred by

What Are You Looking For?

Select your TOP priorities (at most 3)
This helps AI Wellness to prepare your experience beforehand

About You (optional)

This helps AI Wellness to create intentional relationship-building
To ensure your experience runs smoothly

Agreement

VIP Concierge Agreement
How should our Concierge Team contact you?

Your Commitment

Reservation Deposit

Event Reservation Deposit: $250.00

As we can only serve a limited amount of people, we will ask for your commitment and a one-time deposit to lock your experience. The deposit will be deducted from your total investment at the event, but it is not refundable.
Your Concierge Team will review your selections and may recommend additional experiences based on your wellness goals.

Payment for the Deposit