Funk'tional Nutrition 1:1 Membership Application V2

Ready for a deep dive on your health? We're excited to partner with you!

This should only take 5-8 minutes to complete and we'll get back to you within 48 business hours of receiving your application.
Yay! We're so excited to get to know you more. Please tell us your name!*

First NameLast Name
What's your email? (So we can write you back soon!)*
example@example.com
How'd you hear about us?*

The Funk'tional Nutrition PodcastGoogle/search engineInstagram/social mediaWord of Mouth/direct referralOther
Word of mouth! That's awesome! May we ask who?
Please provide a brief description of your health struggles. (If we end up working together, you can drop the WHOLE story down on our first appointment. "It all started on a dark, stormy night...")*
What do you hope to achieve working with us? (Dream big!)*
If you achieved all of these goals, how would you feel? What would you do differently? How would it change your life?*
Have you worked with other nutritionists and/or functional medicine practitioners in the past? If so, what did you find helpful (or not)?*
Have you done any functional testing/labs in the past? (Including, but not limited to, stool tests, SIBO breath test, H. Pylori breath test, hormone testing, adrenal testing, DUTCH test, organic acids test). *
Team FN sees a limited amount of individual clients so we can give our all to each case. Working within the private container of our one on one practice requires an investment of $850 per month. We do not require a minimum commitment, but for optimal results, the average length of time we work with our private clients is around 6 months. Are you ready to make this investment into your health?*

Yes, I'm ready!Not at this time
Functional testing is an integral part of The Funk'tional Nutritionist practice. All labs are cash pay only. You can also use an HSA/FSA card to pay for some labs.

Our practice is unique in that we cater our lab recommendations to the individual client. (It is our belief that the best practitioner is not the one who can order the most labs, but the one who can use the most discernment with which labs to order.)

We do not provide a cookie cutter approach. Instead, the labs we decide to run for you depend heavily on your symptoms, your health history, your finances and our conversation during your initial appointment.

We DO NOT upcharge our labs, but instead pass on our practitioner cost directly to you.
The cost of beginning labs for new clients can be anywhere from $400-$1200. Are you ready and able to make this investment?*

YesNo
We totally respect and understand not being ready for the 1:1 membership investment at this time. We also offer other nutrition & functional medicine programs to make Erin’s methods more accessible and affordable. We have seen profound & powerful healing happen within our program communities — this is a tried and true approach that thousands of clients have had success with! Would you like to learn more about The Funk'tional Nutrition Collective and how to access all our programs for only $149 a month?*

That sounds great!I think I will stick with all of her free resources for now!
What best describes the way you currently eat?*

I eat a primarily whole foods diet (80% or more)I feel pretty confident about the way I eatI am looking for some small tweaks to be sure my diet is optimized for meI know what I ‘should’ be eating but I struggle to actually do itI need a full diet overhaulFood makes me nervous – I am not sure what I’m reacting toI have done Erin’s Eat to Achieve™ programI have done Erin’s Carb Compatibility Project™
Let's drill into the food piece a bit more. Are you currently on any type of restricted diet? Gluten free? Dairy free? Etc. Please tell us a little more about your current way of eating and whether or not you feel like you need assistance here.*
What is your chief issue?*

Digestive troublesFood intolerances/sensitivitiesHormone imbalanceFatigue & Sleep issuesThyroid disorderAutoimmune diseaseOther
Are there any other relevant pieces of information you'd like to add here?
Where are you located? Do you live in MD, NY, NJ, RI or outside of the United States?*
Should be Empty:

Ready for a deep dive on your health? We're excited to partner with you!