Gut Healing Application Form
Thank you so much for your interest in working together. In order to help you better please fill out this form and I will be in touch with next steps ASAP.
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Name (First, Last)
Email
Where do you live
What are your top 3 health challenges? *
What approaches have you tried already that worked for you? Please list: *
What approaches have you tried that did NOT work for you? Please list: *
What changes do you know you could / should make that you haven't already made? *
What are the biggest barriers to making the changes you already know you should be making? *
On a scale of 1 to 10, how committed are you to making the changes you need to make achieve your health goals? (10 being extremely committed) *
What is the one change / new behavior you can commit to making this week that will move you in the direction of your health goal? *
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