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What is your full name?

 
How old are you?

 
Gender?

 
Best phone number?

 
What is your current living situation? Please include partner/children with ages and anything particular about your living situation that I might need to know.

 
What challenges are you currently facing in growing your health? Are there any obstacles you face in taking on these challenges?

 
What are some steps you’ve taken to deal with these current challenges? Consider books you’ve read, practitioners seen, changes you’ve made, etc.

 
How is this health challenge getting in the way of the life you want to live? What would be a positive result in your life if you were able to resolve this current challenge?

 
If you discovered that lifestyle and nutritional changes would help you overcome your health obstacle, how motivated are you on a scale of 1-10 (1 being not motivated, 10 being “I’ll do anything, no problem!”) to take on these challenges?

 
What would get in the way of you making these changes?

 
What about your current circumstances and personality would help facilitate making changes?

 
What kinds of support would be ideal for you given your personality and circumstances?

 
If you found support that seems to fit, are you able and willing to invest financially in order to move your health forward?

Thank you for taking the time to focus on your health!
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