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• Intake: Forms, Instructions & Directions

• Disclaimer

• Health History

• Medication List

• Metabolic Assessment Form

• Neurotransmitter Assessment Form

• Hormones

• Diet Diary and Exercise Log

• Mind / Body Questionnaire

Each person wanting a consultation must:

• Get a note from his/her healthcare provider stating that he/she knows you are seeing a nutrition counselor

• Maintain a food diary for a full week, noting everything you eat and drink and approximate quantities. It may help to jot down how you feel throughout the day near the food intake. It is better to write things down as you eat them, rather than trying to remember it at the end of the day. Accuracy is imperative.

• Print out the Client Intake Forms. Fill them out completely and send them in via fax or mail at least 6 days before your appointment.
  My fax # is 954-941-8220. If you choose to fax them
  PLEASE BRING IN HARD COPIES WHEN YOU COME IN.
  
  Please be advised that:

• Insurance does NOT cover my services and

• Payment must be made in check or cash or Visa/MC only at this time.