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Get My Life Back Program (Application)
Congratulations for making the decision to change your health and your life.  Our 'Get my life Back Program' is just that, a Virtual Health Coaching program to help you get back to doing the things you love regardless of how old you are.  We've all heard that age is nothing but a number, but you've also probably heard from your doctors 'it's just part of getting old'.  At Achieve Integrative Health, we have helped thousands of patients defy the norm.  We believe that your quality of Life can absolutely IMPROVE as you get older, we call it Restorative Longevity.  If this resonates with you, then you're in the right place.

Achieve Integrative Health is proud to have Nutritionist, Chris McKee, join our team to provide this restorative longevity service to people who can't travel to our clinic in Austin, TX.  Chris is a prime example of "been there done that" and she's a living example of Restorative Longevity.  Unlike many health coaching programs online, who are being taught by practitioners in their 20s and 30s, who have yet to experience the effects of aging, Chris is in her 70s and a living example of what it means to age with Grace and Vitality.

This application is to help us see if Chris is the right Health Coach for you.  We want to make sure the Results you desire match the Guidance we provide.  This application is not about saying who is right or wrong, it is purely to help us determine if we are a good fit for you.  The last thing we want is for you to invest your time and money to find out that we can not deliver the result that you want.  So please answer the below questions honestly.  Here are the steps to becoming a client:
  1. After we review your application we will notify you via email, if we think we would be a good fit and if we can help you or not.
  2. If we find that we can help you, then Chris will email you to set up a time for an Initial Evaluation
  3. Prior to your Initial Evaluation, Chris will email you instructions on forms you need to complete and how to prepare for your Initial Evaluation and the program details.
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FREQUENTLY ASKED QUESTIONS:

Is this a Virtual Only Health Coaching program?
  • Yes, this Virtual Health Coaching program is provided via online only, and with our Nutritionist Chris McKee only.
What disorders can this Virtual Health Coaching help with?
  • Digestive Health Concerns (IBS, acid reflux, Crohn's, diverticulitis, constipation, diarrhea, etc)
  • Autoimmune Health Concerns (Hashimoto's, Grave's, Rheumatoid Arthritis, Allergies, etc)
  • Metabolic Health Concerns (Type 2 Diabetes, High blood pressure, high cholesterol, weight gain)
  • Neurological Health Concerns (Anxiety, Fatigue, Depression, Insomnia)
  • Hormonal Imbalance (menopause, pms, PMDD, PCOS, irregular menstruation)

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Name *
First and last name
Email *
How did you hear about this program?  Where did you find us? *
What is your #1 Health Concern and Struggle right now? *
What is your Health Concern preventing you from doing in your life, that you love to do and wish you could do more of? *
What type of Solution are you looking for, for your current health struggle? *
What type of Solution are you looking for, for your current health struggle?
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What type of HELP are you looking for, for your current health struggle?
*
What RESULT are you looking for? 
*
What End Result are you expecting after going through our program?
*
What are you looking for?
*
What's more important to you?
*
What's more important to you?
*
What's more important to you?
*
Which of the below best describes you?
*
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