Basic Nutritional Assessment

List your normal day's intake of the following:

Please note: The material presented by "Pure Nutrition + Wellness" is a result of personal study and experience. The practitioners at Pure Nutrition and Wellness are not licensed physicians.

"Pure Nutrition + Wellness" does not engage in the diagnosis of disease or the prescription of any health program as a cure for disease. The material and resources offered by "Pure Nutrition + Wellness" is intended for educational purposes only. Be sure to consult with your personal physician regarding the treatment of any medical condition.

Thank you for trusting us to help you take charge of your health! Our basic belief here

at Pure Nutrition and Wellness is that the body's natural state is to be healthy! If the body is given what it needs nutritionally, physically and emotionally - good health will prevail. It is our sincere goal to give each client the personalized attention necessary to help them reach their full health potential. This approach is vastly different from most main stream health care options; but spending quality time to listen, teach & empower are vital to the healing process. Each new client welcomed into our practice is given

Donna Stephens' utmost individual attention and personalized care.

It is the policy of Pure Nutrition and Wellness to collect an initial deposit of $59.00* from all new clients when scheduling their first appointment. The $59 deposit will be applied toward the total charge for the first appointment. A valid credit card must be given to keep on file with our office when the first appointment is scheduled. This card will only be used in the event of a missed appointment.

*In the event of a missed appointment, this deposit will be non-refundable without at least 24 hours prior notice. For our Cancellation and Missed Appointment Policy, please see below.

Important Notice for All Pure Nutrition and Wellness Clients

Due the strong demand for office visits and new client appointments, Pure Nutrition

and Wellness requests at least 24 hours advance notice for all appointment cancellations. Please review our policy for cancellations and missed appointments:

Cancellations/Missed Appointments

We do understand that in today's busy world occasionally situations come up that are

beyond our control. In those instances, kindly call 844-787-3935, Ext. 1 and give us 24

hours advance notice if you are unable to keep your scheduled appointment time.

Pure Nutrition and Wellness will charge $59 for cancellations received less than 24 hours prior to appointment time, except for cases of medical emergency, and for all missed appointments.

Clients who would like for us to place supplement orders through the front desk, or who wish to consult with Donna Stephens by phone will need to keep a valid credit card on file with Pure Nutrition + Wellness.

Because we appreciate our clients, we make every effort to create an environment that

It is the office policy of Pure Nutrition + Wellness LLC, Essential Calming Solutions LLC, and Gainesville Bodyworks that our practitioners are available by appointment only. In the best interest of each individual, no outside interruptions are permitted when we are in sessions with clients.

Violation of this policy may result in being refused any further consultation or access to other services provided by the practitioners located in the office at 560 Broadview Avenue, Lower Level, Warrenton, VA 20186.

Thank you for your compliance.