Nutrition Intake and Report Forms
Intake Forms
Lifestyle Assessment Form
To help me best understand your needs, you will fill out a comprehensive Lifestyle Assessment Form. This form compiles crucial information about your symptoms, health history, dietary habits, lifestyle factors, and goals. It serves as a foundation for developing a personalized plan tailored to your specific needs. Allow at least one hour to complete the Lifestyle Assessment form and submit it in advance of your first appointment to make the most efficient use of our time together. Taking the time to complete this form as thoroughly as possible will help me develop the most customized, bio-individual plan possible. Think of the time spent as an investment in your future health and wellness.
Body Systems Balance Form
Whether you are a ‘numbers person’ or not, many people find it helps to have a quantifiable reference point. The Body Systems Balance form provides a ranking of the state of each body system based on your reported symptoms. These scores will be the foundation of your customized plan and a way to measure your progress moving forward. Allow at least 30 minutes to complete the Body Systems Balance form and submit it in advance of your first appointment to make the most efficient use of our time together.
Follow-Up Report
Your follow-up report is included in the cost of each initial and follow-up consultation. It will include a wealth of specific information organized into the following easy-to-understand sections, all fully customized and based on the results of your questionnaires, personal preferences and goals.