Natasha Wellness Application
Thank you for taking the first step toward bettering your health. Please fill out this form so I can get a better idea of how I can better help you. I will be in touch with you within 24-48 hours to set up a time to talk. I can't wait to connect with you.

XO, Natasha

Email address *
First Name, Last Name *
Your answer
How did you hear about Natasha Wellness?
Your answer
What is your current health issue? *
Your answer
On a scale of 1-10 how much is it bothering you right now? *
Not at all
Debilitating
Is it getting worse/better? Please describe. *
Your answer
Do you want to experience a change in the coming years? *
Given the current trajectory you're on do you think this problem could be a bigger problem in the future? *
How invested are you in working with this problem? *
Not at all
EXTREMELY
What are your biggest fears and frustrations with aligning with your total wellness? *
Your answer
What problems are these fears and frustrations causing in your life? *
Your answer
What are your biggest desires in life? *
Your answer
How would your life change if you were aligned with your total wellness? *
Your answer
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