Internal Healing Method Enquiry Form

Welcome, my name is Lauren! ✨

I’m here to guide you on your journey toward inner healing, balance, and clear, radiant skin.

A little about the process:

True healing begins from within. Every person’s mind, body, and symptoms are unique, and my goal is to create a personalised protocol that supports you exactly where you are.

This form is designed to help me understand your unique needs so I can offer a plan that is:

* Holistic and nurturing
* Grounded in proven techniques and practices
* Fully aligned with your individual needs, goals, and lifestyle

The protocol I create for you will be completely tailored to your circumstances, challenges, and intentions. Once your plan is finalised, I will guide you step-by-step on how to implement it, making the process simple, supportive, and seamless.

To ensure I create the most effective plan for you, please answer all questions as thoroughly and honestly as possible.

Let’s begin your journey to inner healing and transformation! 🌿✨

⏱ Please note: Responses are provided within 2–3 business days (excluding weekends).

For a faster reply, feel free to DM me on Instagram once you’ve submitted your form.

I’m so excited to support you on this journey of self-healing and growth! 💕

Name

First NameLast Name

Email

example@example.com

Instagram Handle (if applicable)

D.O.B

Date

Occupation

Why do you want a place on The Internal Healing Method?

Please give a detailed description of your current skin concerns? Include previous history and dates where possible.

Are you currently using any method of contraception?

Have you ever been placed on contraception for any other reason than to prevent a pregnancy? Eg) Heavy or painful periods, acne.

YesNo

Do you currently have a skincare routine?

YesNo

If yes, what are you currently using in your regular skin routine? AM & PM. Please be as detailed as possible, including brand names.

Do you or have you ever had any diagnosed health conditions? Please be as detailed as possible.

Have you ever been diagnosed with PCOS, Endometriosis, Ovarian Cysts or Fibroids?

YesNo

If you have been diagnosed with PCOS, how was this found?

Blood WorkUltrasoundBoth

Are you currently taking any medication? Please be as specific as possible, including names and doses.

Have you ever been prescribed or used any medication for acne? Oral or topical. Please be as specific as possible, including dates and doses.

Are you currently taking any supplements? Please be as specific as possible, including brand names and doses.

Could you be pregnant or are you trying to become pregnant?

Do you smoke or vape?

Do you use or take recreational drugs?

YesNo

Do you have any menopausal issues? If so, are you under-going hormone replacement therapy?

Are you following any diet plans? Please be specific with this.

Do you have any dietary preferences?

VeganVegetarianPescatarianOmnivorous (you eat meat, fish, plants)

Are you currently working with any other health practitioners? Eg) personal trainer, nutritionist, fitness coach.

Do you have a specific goal or event that you would like to achieve your skin goals by?

Please upload a photo of your skin.

The Internal Healing Method requires blood work to be taken allowing Lauren to analyse the results along with your presenting symptoms. A targeted protocol will be devised to address the root cause of your acne permanently. Because of this, it is essential that all participants are committed to the programme and understand that accountability is essential in achieving the results. Therefore, we will only accept people who are dedicated and ready to change their lives and their skin, for good. Are you prepared to make this commitment?

Yes, I will be 100% committed to the programme and the process.No - I don’t think is for me. (If this is the case, please don’t submit the form)