Best Email Address to Contact you
Best time to text or call you?
Current Diet, Mostly
Please use a few words to describe your breakfast, lunch, dinner. What you eat and what you like to eat
Current Morning Weight
Height in inches
Do you like your weight?
Your Ideal Weight
Do you have Risk Factors for
List Prescription Medications, OTC and Supplements
When is the last time you felt healthy and thriving?
If you could wave a magic wand, what is the thing you wish for most in the arena of health?
Are you willing to make changes to your nutrition and lifestyle habits?
General Mood Scale of 1 to 10 from Depressed to Exuberant
General attitude towards life
Exercise How much do you exercise in a week and how do you exercise?
Sleep Do you get 7-8 hours of sleep a night. If not, what keeps you from sleeping?
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