Discovery Call

Fill out this form by being as specific and honest with both yourself and me as possible. I AM NOT HERE TO JUDGE, I am here to support you to reach your goals. My ultimate goal as an FDN Practitioner is “what are the stressors, how can we reduce your stress, and what can I do to support you to heal?” Once I receive the completed form, I will contact you to schedule the call.

Your Info

First Name

Last Name

Phone Number

Date of Birth

About Your Health

Have you worked with a holistic lifestyle coach in the past? If so, when?

What is your main health complaint? If I had a magic wand to change that "one thing" - what would it be?

How often does it bother you?

When did the problem start? How long has it been going on for?

What have you tried so far that does not work?

How does this affect your life, or what does it prevent you from doing?

Who or what (fear, money, time) may stop you from completing a health rebuilding program? Who will support you?

Part of my job as a Functional Diagnostic Nutrition Practitioner is to help establish reasonable goals and readiness for changes. What would you expect to achieve while working with me?

On a scale of 1-10, how important is it to solve this health complaint?

How did you find me? Who can I thank for connecting us?