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The Signature Match: Application & Intake

You're in the right place.

This application helps us understand your needs, history, preferences and goals so we can prepare for your 1:1 Signature Match session and thoughtfully curate aligned wellness providers.

We accept a limited number of Signature Match clients at a time. Applications are reviewed on a rolling, first-come basis.

Complete the application below and you’ll hear from us shortly with a link to book your consultation directly.

Note: if a question does not apply to your request, just put "NA"

Full Name

Email

Phone Number

City

How do you prefer sessions?

How do you prefer sessions?
A
B
C

When are you hoping to begin?

When are you hoping to begin?

When are you generally available?

When are you generally available?

Budgeting & Service Costs

Investment varies widely based on type of service, experience, format. Many providers offer both single sessions and packages that can vary in cost.

What investment level feels realistic right now?

What investment level feels realistic right now?
A
B
C
D

Do you plan to use insurance or HSA/FSA?

Note: some services/providers do not accept insurance
Do you plan to use insurance or HSA/FSA?
A
B
C
D

If you plan to use insurance, which insurance plan do you have?

What are you seeking support for? (Select up to 3)

What are you seeking support for? (Select up to 3)

If other, please list here

How urgent does this feel for you?

How urgent does this feel for you?

Is there a specific type of provider/expert you're looking for that wasn't listed?

Provider vibe - what fits you best?

Provider vibe - what fits you best?
A
B
C
D
E
F

What would you like to avoid in a provider or their approach?

Have you worked with providers for this before?

Have you worked with providers for this before?
A
B
C

If yes, what worked and what didn't

Current diagnoses or considerations you want your provider to know?

Current medications or supplements? (NA if not applicable)

What phase of life best describes where you're at?

What phase of life best describes where you're at?
A
B
C
D
E
F
G
H

In your own words: what feels off, what’s weighing on you and what would feel like relief?

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Terms & Policies

By submitting this intake and booking a Signature Match Session, you acknowledge that The List provides personalized referral and matchmaking services only. The List does not offer medical care, diagnosis, treatment, or clinical guidance, and participation does not create a patient–provider relationship with The List.

All matches and recommendations are based on the information you share and are intended for informational and referral purposes. You are solely responsible for evaluating any provider’s qualifications, licensure, scope of practice, availability, and fit before beginning care.

While every provider within our network is vetted with care, The List does not guarantee outcomes, results, or specific improvements, and is not liable for the actions, advice, or treatment you may receive from any referred practitioner.

Refund Policy Because each curation is created individually and work begins immediately upon booking, all payments are non-refundable once your Signature Match Session is scheduled. If you believe a payment was made in error, please reach out within 24 hours at olivia@thelistwellness.com for review. Requests received after 24 hours cannot be accommodated.
Satisfaction Policy

Matches are curated based on the details you provide, but The List cannot guarantee a perfect fit with every provider. If you feel a recommendation isn’t aligned, you may reach out within 7 days to discuss options.