Let's understand your family's story
Every family has a unique relationship with food. Before our first conversation, I'd love to understand your current situation, your goals, and the kind of support that would make the most difference for you. After you submit this form, my team will reach out within 3 business days with clear next steps.
Contact Information
Full name of parent/guardian
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Primary email
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example@example.com
Phone number (with country code)
*
Please enter a valid phone number.
Format: (000) 000-0000.
City, province/state, and country where your family currently lives
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Preferred method of contact
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Email
Phone call
Text message / WhatsApp
Who the Consultation Is For
Who is this consultation for?
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My child
More than one child in our family
Parental guidance / family session (no child present)
I'm not sure which format fits best yet
Child's first name
So Milene can refer to them personally.
Child's age range
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Under 1 year
1 to 2 years
3 to 5 years
6 to 8 years
9 years or older
Your Family's Needs
Which consultation sounds closest to what you're looking for?
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Pediatric Nutrition Consultation (understanding feeding behavior and building a plan)
Family Session / Parental Guidance (mealtime dynamics, routine, posture)
Follow-up Session (I've worked with Milene or a similar professional before)
I'm not sure yet — I'd like Milene's recommendation
Consultation format preference
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Online (anywhere in the world)
In-person in Ottawa
I'm open to both
What brought you to reach out now?
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What is your main concern today?
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Selective / picky eating
Food refusal
Difficulty introducing solids
Mealtime stress, conflict, or exhaustion
Disorganized feeding routine
Questions about supplementation
Difficulty planning balanced meals
Caregivers not aligned on approach
Other — I'll describe below
What would you like to achieve through this consultation?
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Context
How long has this situation been part of your daily life?
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It started recently
A few months
More than a year
Since we started solid foods
I can't say for sure
Has your family sought help for this before?
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No, this is our first time
Yes, with a nutritionist or dietitian
Yes, with a pediatrician
Yes, with a feeding therapist or occupational therapist
Yes, with a multidisciplinary team
If you answered yes above, how was that experience?
Is there any health condition, diagnosis, allergy, dietary restriction, or important information we should know before our first contact?
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No
Yes
If yes, please describe briefly
Your Journey Today
Where are you in your decision process?
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I want to schedule as soon as possible
I want to understand which consultation is right for me
I'd like more information before deciding
How did you find Milene's work?
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Instagram
Referral from a friend or family member
Google search
Course or program
YouTube
Another social media platform
Her lecture / event
Other
Consent
I authorize the use of the information I'm sharing for the purpose of organizing my consultation.
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Yes
I understand that submitting this form does not automatically confirm a booking, and that Milene's team will contact me to coordinate the next steps.
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Yes
Request my consultation
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