Schedule your 1-on-1 Consultation

What does my consultation include?

- A 1-on-1 video consultation (up to 1-hour)

- Guidance to help you meet your wellness goals

- and more

Consultation Cost: $260 (includes everything listed above provided via video or phone call)

Questionnaire

This helps us prepare for your 1-on-1 consultation. We typically spend 2-3 hours, after we receive your Questionnaire, researching prior to your scheduled consultation. Please answer truthfully and be as detailed as possible.

Your Full Name *

Phone Number *

Your Email *

Home/mailing address *

Age *

Gender *

Preferred consultation method *

Current weight *

Desired weight *

Height *

Allergies *

Prior surgeries or hospital stays *

Mental health diagnosis *

Diagnosed medical conditions *

Do you have children? Ages? *

Are you pregnant or breastfeeding? *

How much sleep do you get nightly on average? *

Are you employed? *

What is your occupation? *

How many bowel movements do you have per day? *

Tell us about your family health history *

Do you have any food sensitives? *

Do you have any diet restrictions? *

Please provide us with an example of your daily diet (foods you eat daily) *

What supplements are you currently taking, if any? *

What prescription medications are you currently taking, if any? *

What are your current, biggest health concerns? *

What are your main 1-3 goals regarding your health and wellness? *

If you were to have a perfect outcome after beginning a nutrition and supplementation program (6-9 months down the road), briefly describe what that would look like for you. *

Additional questions or concerns

Describe your field here.

Do you smoke cigarettes or use nicotine? *

never

rarely

sometimes

often

Do you drink alcohol? *

never

rarely

sometimes

often

Do you exercise? *

never

rarely

sometimes

often

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Disclaimer and Agreement *

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Make sure to read our full disclaimer before submitting your answers.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Schedule your 1-on-1 Nutrition Consultation

with our experienced Team

What does my consultation include?

Questionnaire

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