Welcome! We are so excited you’ve made the decision to improve your wellbeing and quality of life through nutrition therapy. We find it very helpful to learn a little bit about you prior to our first session. This helps us to better understand your needs, preferences, and goals in order to offer realistic and personalized care for your health concerns.

You will receive an electronic version of the forms upon scheduling and there is no need to print the copies below. However, if you prefer to print and handwrite out your response, please let us know that you do not need the electronic version.

If you become overwhelmed, find any of the questions challenging, or don’t feel comfortable answering, please leave them blank. Only complete the sections which feel appropriate to you to complete.



Policies aNd

Consent for Treatment
and Authorization