Application Page We are no longer taking on new clients for 2020. If you'd like to be added to the list for January 2021, please fill out the form belowName* First Last Email* Phone*What is your most pressing health concern?*Autoimmune DiseaseFatigue and Energy LevelsFood Sensitivities & IntolerancesHormonal ImbalancesGut HealthPlease expand upon your selection from above (I.e. which autoimmune disease; which diagnosed/suspected hormone issues; severity of fatigue; specific bowel issues, etc.)*If you could magically change 3 things about how you currently feel, what would those be?*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.Nutritional therapy is not the easy way out. In fact, it requires patience, consistency, and steadfast implementation.Are you at a place in your life where you can invest time, energy, and finances toward reclaiming the best version of you?*We reply to all applications within 2 business days. Please check your SPAM folder!Submitting an application will automatically add you to the CFW newsletter mailing list. You can unsubscribe at any time. Looking forward to working together!NameThis field is for validation purposes and should be left unchanged.