Functional Freedom Success Story Form

Submit your Functional Freedom success story!

We'll use your responses to feature your success on our social media outlets, our program pages, and through our various Prime marketing outlets. Please let us know if you don't want to be featured by name, as we can also feature you as anonymous.

Name(Required)

First Last

Date(Required)

Please choose how you would like to be featured below(Required)

Feature me anonymously by taking out my name and picture please

I'm fine with including my name and picture with my story

Email(Required)

Phone(Required)

Would you like to include any pictures? Please submit any before/after pics or a pic to be featured along with your success story below.

Drop files here or

Max. file size: 50 MB.

Would you like to include any pictures? Please submit any before/after pics or a pic to be featured along with your success story below.

Drop files here or

Max. file size: 50 MB.

Driver/User Code(Required)

Truck Number (if applicable)

Tell us a little bit about your starting situation prior to joining Functional Freedom. What was your health like before joining our program?(Required)

What prompted you to join our Functional Freedom program or join DHF?(Required)

What did you do or change as a result of being in our Functional Freedom program?(Required)

What was the end result of being in our Functional Freedom program?(Required)

Thanks for all your hard work!

We'll be in touch if we have any questions about your success story form!