Contact Information (Confidential)
On a scale from 1-10, how would you rate your health?
What is your current health-related goal?
What is your favorite meal of the day?
What is your least favorite meal of the day? (or the one that life makes you skip the most)
Do you drink water?
Do you currently suffer from an ongoing medical condition?
Are you worried about any potentially inherited medical conditions?
How many hours of sleep do you average per night?
Do you exercise regularly?
Do you currently take any vitamins or supplements?
Describe your typical day from a nutritional standpoint.
Would you like to learn more about living a healthy life and how it can benefit your work?