Right Fit: Thyroid Counseling
After you complete the information in this form, please go to calendly.com/support-131 and schedule your 20 minute call.
Email address
First name
Your answer
Last name
Your answer
Phone number (best number to reach you at)
Your answer
What state do you live in? (We can work virtually from any state, but this helps us determine which labs we can order)
Your answer
What is your health insurance? (This helps us determine which labs we can order)
Your answer
Age
Your answer
Do you have a thyroid diagnosis? If yes, what is it? How long have you had it for?
Your answer
Do you have thyroid related symptoms? Please list.
Your answer
List any other health conditions that you have.
Your answer
What have you tried (diet, lifestyle, medications) in the past? Tell me what worked and what didn’t.
Your answer
Please e-mail all labs that you have done in the past 6 months to support@nourzibdeh.com. We can't work together without proper thyroid testing. Your information will be protected.
What’s your biggest challenge with your health?
Your answer
If we decide to work together, how can I help you best?
Your answer
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