Application Page Apply to work with me! I only take on a limited number of clients so that my time and focus is dedicated to YOU. Our relationship develops into an intimate partnership in which we both work hard to get you feeling your best. By applying to work together, there is a mutual understanding that you are ready and willing to make changes in your diet and lifestyle to achieve holistic wellness. Name* First Last Email* Phone*What is your most pressing health concern?*Suspected food sensitivities and intolerancesBloating and other gut related issues (constipation, diarrhea, irregular bowel movements)Irregular/absent/painful periods, concern for hormone imbalancesPain and inflammationFatigue and energy levelsSkin issuesAutoimmune disease (Hashimoto’s, Rheumatoid Arthritis, etc.)Just want a check up for prevention and general wellnessWhat are your top three major complaints about how you currently feel?*Please describe how you envision your relationship with Nicole as your Registered Dietitian Nutritionist.*In the past year (or currently), have you worked or are you working with another Registered Dietitian/Nutritionist and/or a Medical Doctor?*On a scale of 1-5, how motivated are you to make major changes in your diet and lifestyle to achieve your goals? (5 being the most motivated)*Please enter a number from 1 to 5.Are you at a place in your life where you can invest in your health to rediscover the best version of you?*By submitting this form, you will be added to my mailing list. (You can unsubscribe at any time!) Looking forward to working together! CommentsThis field is for validation purposes and should be left unchanged.