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30 minute Virtual Consult with Dietitian, Kelly Clark
Complimentary 30 minute clean cooking/living consult.
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* Indicates required question
What is your name?
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Your answer
What is you email address?
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Your answer
What is your phone number
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Your answer
How health conscious are you on a scale of 1-10?
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Very little
1
2
3
4
5
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7
8
9
10
Health and nutrition are everything!
Please check any and all health history in your immediate family.
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Cancer
Diabetes
High blood pressure
Autoimmune
High cholesterol
Food Allergies or intolerances
Digestive Disorders
Hormone inbalance
Trouble maintaining or concerns with weight gain or loss
Other:
Required
Who does the cooking?
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You
Spouse/Partner
Other
Do you consider cooking healthy a challenge?
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Yes
No
What type of cooking surface do you use?
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Cast iron
Stainless Steel
Ceramic
Enamel/ glass
Non-stick
Required
In your daily meal planning, what is the most important to you?
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Time savings
Cost
Health benefits
Flavor
Other:
Required
What is your profession?
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Your answer
What is you age group?
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20-30 years
31-50 years
50-65 years
65+
What is the best time for a virtual consult?
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Morning
Afternoon
Evening
See you Soon!
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