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Client Application
Apply for a Consultation

This application allows Dr. Lederman to review your situation in advance so your consultation is focused, strategic, and personalized from the start.

You may have shared parts of your story elsewhere — that’s completely okay. Having everything in one place ensures we use your time together thoughtfully and at a high level.

Because of the volume of families reaching out, completion of this application is required prior to scheduling. Each application is reviewed carefully to assess fit and ensure that every consultation is meaningful, relevant, and aligned with your specific needs.

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Email *
1. What made you book this call now instead of waiting?
(What changed? What feels urgent?)
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2. Briefly describe the main medical situation or decision you want help navigating. (Please include diagnosis, stage if known, current treatments, and any decisions you are weighing.)
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3. What have you already tried to address this, and why hasn’t it fully worked?
(Medical consultations, additional opinions, supplements, alternative protocols, lifestyle changes, etc.)
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4. If nothing meaningfully changes over the next 3–6 months, what does that cost you?
(Emotionally, relationally, physically, financially, or in quality of life.)
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5. What would “this actually worked” look like for you?
(Clarity? Stability? A coordinated plan? Improved sleep or energy? Reduced fear? Something else?)
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6. What is the most medically or emotionally volatile decision you are currently facing?
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7. How important is it for you to resolve this now (1–10), and why did you choose that number?
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8. Which best describes your current situation?
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9. This program requires structured weekly participation across medical strategy, internal terrain work, nervous system regulation, and food system implementation. Are you willing to actively engage in that process?
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10. Are you in a position to make a decision yourself if this feels like the right fit during or shortly after the consultation?
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If you answered “No” above, please briefly describe who else needs to be part of the decision:

11. Before moving forward, please confirm which statement best reflects where you are right now:

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12. Is there anything else Dr. Lederman should know before the consultation?
(This may include fears, prior trauma, family dynamics, or concerns that may not fit elsewhere.)
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