Discovery Session Form

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I'm so excited to meet with you! Sharing the answers to these questions will help us get to know each other better and will save time during our discovery session. This gives us more time to focus on how I can help you and what we should focus on.

As always, please feel free to contact me with any questions.

In good health!
Holli Bassin

Email *

Name

Who referred you to me? *

What is your biggest challenge related to your health? *

How does it feel in your body? (Symptoms)

Describe how it effects your life. *

What would you like to be able to do feel or experience in your body or in your life that is difficult for you now. *

How committed are you to working with to me? *

Right now... *

I have the financial resources to invest in my health. (Starting program costs are $500 - $1,000)

I am willing to get resourceful to find the funds because I know how important this is.

No, I don't have any financial resources at this moment to invest in my health.

Required

How much have you invested in your health so far? What was the result?

Is there anything else you would like to share with me?

Send me a copy of my responses.

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