Lets get started! Once we've decided to work together, please take the time to fill out the following intake form. I look forward to working together and supporting you on your health journey!

Name *
Please submit a 3-day diet diary. I want to get an idea of what your daily routine looks like (there are no wrong answers here!) Please list food allergies, sensitivities & restrictions.
How do you care for your mind? Your thoughts? Do you seek the support of a therapist or spiritual counselor or have you done so in the past?
Tell me a bit about the current state of your body and health. Energy & Happiness levels? How do you care for your body (daily, weekly, monthly) Do you exercise? If so, what activities do you enjoy?
In what ways do you care for your spirit? Do you have a Spiritual Practice? How much time do you spend in nature? Do you have a meditation practice of any kind?
What's your life like? What do you do for fun? What are your interests? (Activities & hobbies) Tell me a bit about your daily/weekly/monthly rituals surrounding self-care + wellness practices like exercise. Are you working with any health practitioners? (acupuncturist, massage therapist etc)
Please list any vitamins, probiotics, herbs, superfoods, supplements or medications you are taking.
List your top 3 health goals and anything that you feel is standing in the way of your progress.