Destination Vitality Ltd


  • Home
  • Mission
  • About Me
  • Services
  • Forms
  • More Information
  • Extras
  • Shop & Discounts
  • THE VITALITY REVOLUTION CO
  • Contact

Forms :



information to help me help you.





Have Questions? Please use the online booking link to schedule a free call where I will be happy to answer your questions. - After you book, you will receive an email with forms to complete - Please complete these prior to your call and please include your questions.



Waiver for equipment use





To streamline your visit & save a tree fill out the waiver prior to your visit for therapeutic equipment use

JadeMassageRollerTableWaiver ZeroGravityChairWaiver

Forms are available on the patient portal & appropriate forms / consents will be sent to you automatically with booking via the patient portal. For Virtual Visits , General Care, Functional Medicine, Same Day Visits





Set up your account with booking-

if you scheduled via phone - check email for portal invitation




310 Sunrise Ave. Honesdale PA 18431


Existing Patients Portal
Create New Account
Optimantra :Online Booking

Dana Gallik MSN, CRNP, FNP-C, CFMP