Apply to Book a Free Consultation
Please answer the following questions as they pertain to your food and body image struggles.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
What are your top 3 main complaints (problems, issues, pain points?)
What are your top 3 goals? (the immediate problems related to food and body you want to solve)
What are your top 3 desires, wishes, dreams? (bigger picture - what are food and body struggles preventing you from pursuing in life)
How would you describe your current life?
What are your aspirations in life?
What are your fears?
What do you believe about health, weight, and food?
What is your dieting/wellness history?
Do you have any specific descriptors you identify with? (pregnant, obese, sick...)
Do you work? What profession(s) have you had/do you have?
What do you do in your spare time? Types of hobbies? Interests outside of profession and health?
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