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Megan Andersen Nutrition Consulting Inquiry Form
Are we a good fit for each other? Answer the following questions before our 20-minute curiosity call. This information will be kept confidential and will help us both determine the best path for future care.
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Email
*
Your email
Have you ever been clinically diagnosed with an eating disorder?
*
Yes, and I am in recovery and relapse prevention as of 5 years or MORE ago.
Yes, and I am in recovery and relapse prevention as of LESS than 5 years ago.
Yes. I am currently in treatment with a team of medical and mental health professionals.
No, but I am concerned I may have an eating disorder.
No. I have never been diagnosed, nor am I concerned I may have an eating disorder.
How many attempts have you made to lose weight through dieting in the past?
*
None
1-3
4-6
7 or more attempts
Which of the following are
ideal
health and wellness goals for you? Check all that apply.
*
Experiencing peace of mind/body more often than experiencing stress
Moving freely without pain
Cooking regular homemade meals
Eating a variety of foods from every food group
Modeling food and body peace to my children
Sleeping restfully and adequately at night
Eliminating foods that cause inflammation
Managing a specific health diagnosis (diabetes, anemia, Celiacs disease, high blood pressure, etc.)
Consistent peace with my food choices
Eating regular, well-rounded, satisfying meals and snacks
Preventing nutrition-related diseases (heart failure, cancer, Type 2 diabetes, etc.)
Exercise that burns as many or more calories as I consume
Making food choices based on nutrition information and ingredients
Eliminating chemicals, additive, sugars, and saturated oils/fats from my diet
Experiencing sustained energy throughout my entire day
Emotionally and mentally resilient
Eating a "clean" diet
Feeling full more often than feeling hungry
Losing weight
Consistent exercise that I look forward to doing
Feeling hungry more often than feeling full
Eating on a scheduled regimen
Other:
Required
How much
outside support
do you have in making healthy behavior changes?
*
Little to none
1
2
3
4
5
6
7
8
9
10
The highest
How
confident
do you feel in making healthy behavior changes?
*
Little to none
1
2
3
4
5
6
7
8
9
10
The highest
How
ready
are you to make healthy behavior changes?
*
Not ready
1
2
3
4
5
6
7
8
9
10
I'm already taking action
How willing are you to put weight loss on the back burner while we work to improve your relationship with food and your body?
*
Not willing at all
1
2
3
4
5
6
7
8
9
10
Totally willing
Megan's Services and Nutrition Consulting Packages
Free: Tips for making peace with food and your body AND five family dinner ideas emailed in my weekly newsletter. Subscribe
here
.
$200: Thirty days of custom meal plans for breakfast, lunch, and dinner. This option is for clients with specific food sensitivities/allergies.
$1000: Eight one-on-one (60-minute) nutrition coaching sessions over 4 months, unlimited access to me on Marco Polo, monthly masterclass, biweekly custom meal plans
$2000: Sixteen one-on-one (60-minute) nutrition coaching sessions over 4 months, unlimited access to me on Marco Polo, monthly masterclass, weekly custom meal plans
Megan's consulting packages require a minimum of a 4-month, $1000 commitment (payment plan is offered). Is this a commitment you can prioritize?
*
Yes
No
I'm here for the $200 custom 30-day meal plan for food sensitivities/allergies
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