Application for Health Strategy Sessions

Hi there!

Thanks so much for your interest in my health strategy sessions!

Please fill out this short application so I can make sure we’re a good fit for each other!

I’ll send you a follow up email after I’ve read your application with an invitation to book a spot.

Thanks and I look forward to reading your application!

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Name: *
Email address: *
How did you hear about me? *
Required
What health concerns would you like help with?
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Where are you located?
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Please list the types of providers that you currently work with and how they support your health.
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Have you worked with a naturopathic doctor or Chinese medicine expert before? *
Why are you interested in working with me?
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Limitations: I can only provide recommendations and education for your health condition from the perspective of naturopathic and Chinese medicine. These recommendations include lifestyle, diet, and supplemental suggestions. Please note that I can’t diagnose you and provide treatment. Any recommendations should be discussed with your other healthcare providers.

Do you understand and agree?
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Would you like to apply for a reduced rate for your coaching session with Dr. Liz?
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If yes, please check the following that apply to you:
*Please use this link to look up your area's median income (AMI): Area median income
Once you find your AMI, multiple that by 0.60. If your income is less than that number, you qualify.
Please tell me why receiving a reduced rate would be beneficial to you:
Do you have any questions for me?
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