Apply for a Complimentary Clarity Call with Christine Waltermyer
Thank you for your interest in working together! 

Since we get a lot of inquiries and have limited availability, this questionnaire helps us pre-determine whether working together could be a good mutual fit on your healing journey before we set up a call to discuss next steps.
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Email *
Name:
 *
Phone Number: *
Which state in the U.S. do you live in? *
What are your health and nutrition goals you hope to achieve through working together? Please be specific! 
(For example, instead of saying "be healthy", please share the specific aspects of your health you would like to improve, and why.)
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What (if anything) have you already tried in the past to address this health issue, and why do you think those approaches didn't work? 
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What would it feel like to achieve the results you desire?
 *
What is holding you back from getting these results?
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What is your level of commitment on a scale of 1-10, with 10  being the highest?
 *
Lowest
Highest
Which of the following BEST describes you?
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How soon are you hoping to get started?
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How did you find us?!
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Thank you for taking the time to fill out this application! 
I'm so honored you are considering having me on your healing journey.
The last step is to SCROLL DOWN & hit the "Submit" button at the very bottom. 
You'll receive an email copy of your responses after you hit "Submit."
After my team has reviewed your application, someone will get back to you via about scheduling a call if we have openings and we believe this could be a great mutual fit.
A copy of your responses will be emailed to the address you provided.
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