I truly want you to reach your health & wellness goals, and I appreciate the opportunity to work with you. To ensure that my services are right for you and that you feel comfortable moving forward, I'd like to get to know a little about you, your story, and your goals. Please complete the confidential pre-consultation questionnaire below. Once submitted, you will receive a link to schedule your 15-minute ZOOM strategy session with me.

Thanks!

STRATEGY SESSION PRE-CONSULTATION QUESTIOnnaire:

Where are you located (City, State) and what time zone are you in?*
What are your main goals for seeking health & wellness/functional nutrition counseling? (Select all that apply and fill in if needed)?*
Do you have any known health or medical conditions or diagnosis that I should know about in helping you to find the best care? If yes, please explain.*
What have you tried so far to reach your goal? (Diets, testing, programs, etc)*
Which of the following items are currently in your diet in ANY amount: (Select all that apply)*
What percentage of your meals are currently home cooked?*
Please let me know anything else about you and your goals for working with me.*
I am committed to working with individuals who are dedicated to their health and ready to receive support on thier individualized journey to health and wellness. In a few sentences, tell me something about yourself and history that will help me get to know you before we dig deeper into your concerns. *

Amount to be charged:

Payment Info


  
 


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