Apply for The JIA Blueprint

Tell me a little about your child, your family, and where you are right now. I personally review each application to make sure the JIA Blueprint is the right fit for your family.

JIA Blueprint Application

Parent/Guardian Information

First Name *

Last Name *

Phone *

Email *

Second Parent/Guardian Information

Full Name

Second Parent/Guardian Email

Second Parent/Guardian Phone

Child Information

Child's Full Name *

Child's Age *

Child's Diagnosis/Diagnoses *

How long has your child been dealing with these health concerns? *

Please tell us a little about what your child is currently experiencing. What symptoms or challenges are you most concerned about? *

What treatments, therapies, diets, supplements, medications, or other approaches have you tried so far? What helped, even temporarily, and what didn’t? *

Is your child currently taking any medications? If yes, please list them. *

What is your biggest struggle or concern with your child’s health right now? *

What would you most like to see change for your child over the next 6-12 months?

Your Family's Health

How many children are in your household? *

Are any other children or family members dealing with autoimmune, neurological, hormonal, digestive, or other ongoing health concerns? If yes, please explain. *

Are there any other health concerns within your household that you would like support with as part of this process? Please explain. *

Your Readiness and Commitment

Which best describes where you are right now? *

We are just beginning to explore our options.

We have tried several things but still aren't getting the results we need.

We have tried almost everything we know to do and feel like we need a more comprehensive approach.

We are ready for significant support and guidance to help us move forward.

The JIA Blueprint is a high-touch, comprehensive program that requires active participation from the family. Are you prepared to invest the time and energy necessary to make meaningful changes at home? *

We’re ready to make this a priority and take action.

We’re ready, but we know we’ll need significant guidance and support.

We’re interested, but we’re not sure we’re ready to make major changes yet.

If you feel the JIA Blueprint is the right fit for your family, are you prepared to make a financial investment in getting this level of support? *

We are prepared to move forward financially if we determine it’s the right fit.

We would need a payment option to make this possible

We would need to discuss the financial commitment further before deciding

We are not currently in a position to invest in this level of support.

Why do you feel now is the right time to get additional help for your child and family? *

If your application is accepted, how would you like to move forward? *

I am ready to enroll at $497/month

I'd like to explore extended financing options

I'd like to speak with Starr and ask a few questions before enrolling

Email and SMS Consent *

I agree to receive emails and text messages from The JIA Blueprint regarding my application, resources, program information, and related updates. Message and data rates may apply. Message frequency varies. Reply STOP to opt out of texts. Consent is not a condition of purchase.

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