90 Minute Intensive Intake Form
I can't wait to get to know you! To ensure you get the most out your 90 Minute Intensive, I want to know all about your challenges and goals. Make sure to complete this at least 1 week before our session. I review this in detail before your Intensive. Keep an eye on your email - I may have additional questions or a little homework in preparation for your call! :-)
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Email *
First Name *
Last Name *
Date *
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Email *
Phone Number *
Would you prefer FaceTime, Google Meeting, or a phone call? *
Date of birth
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Height
Current weight
Weight 6 months ago
Weight 1 year ago
Would you like to be a different weight? If so, how?
Relationship status
Do you have any pets or children?
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