Please complete and send each of the 4 sections.

Thanks!

Nutritional Therapy Step 2/4

In order to work well together as a team to meet your health goals, I need to know a little more about you!
Name

Email

How would you describe your current state of health?

How motivated are you to change your routine or eating habits?

Are you happy with your weight?

How many meals do you eat away from home each week?

Do you most often eat alone or with others?

Do you cook?

Are you currently following one of these diets:

How would you describe your relationship with food?

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