Client Application
Thank you for being here and taking a big step in your health! I am excited to get to know you better and by filling out this application, I will have a better idea of what to expect for our clarity call.
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What is your full name? *
What is your email address? *
What is your phone number? *
State/Region you are located? *Only accepting US based clients at this time* *
What prompted you to reach out at this time? *
What are your health goals for the next 6-12 months? Be as specific as you can.
What have you tried to address your health concerns?
Keep in mind diet, supplements, other programs, medical visits, etc.
What do you think have been the biggest barriers that have prevented you from reaching your goals?
How has your life been negatively impacted by your present health issues and what have you done previously to try and solve this?
How ready are you to commit to improving your health and wellbeing right now?
Not ready
100% Ready
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Taking an individualized approach is a way to get answers and has helped many people; however, it requires both an emotional and financial investment. How much money are you ready to invest to help improve your health right now?
*Please note that 4-month deluxe packages start at $2500 and 4-month Basic packages start at $1500.
Clear selection
Thank you!
You should be hearing from me within a week to set up a clarity call via email! Please make sure to check your spam folder or add nutritionwithmichal@gmail.com to your contacts.
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