Click HERE to see what it’s like to work together! Apply to work together! Accepting new clients for October/November 2021. Please be sure to check SPAM as we aim to reply to all applications with 48 business hours. Name* First Last Email* Phone*What state do you live in? What age bracket best defines you? (in years)20-2526-3031-3940-5050-6060 +How did you hear about us? What is your most pressing health concern?*Fatigue & Energy LevelsHypothyroidismSuspected food sensitivitiesPCOS (polycystic ovary syndrome)Autoimmune DiseaseeSuspected Hormone ImbalancePlease expand upon your selection from above.*Do you have thyroid disease?YesNoI suspect I doI've been told I am "borderline"What prompted you to reach out right now?*If you could magically change 3 things about your health right now, what would those be?*Describe how you've tried to manage your health concerns in the past.*(This may include supplements, medications, diet changes, gym memberships, doctor's appointments, etc.)What obstacles or challenges have hindered you from achieving your goals on your own in the past?*Where do you see yourself a year from now when you begin to prioritize your health and nutritional changes?*(Get specific! The clearer the vision, the easier the path!)Please describe how you envision your relationship with Nicole as your Registered Dietitian Nutritionist.*Changes in body weight often come during your nutritional therapy as the body works toward healing. The number on the scale can be a metric of assessment (if you'd like!), but not our primary focus. (Select one below)Not really concerned about weightWeight loss would be great, but not my main concernAw, shucks. That's my main goalMajor, life-changing improvements can be seen in as little as a few months, but nutritional therapy is not a quick fix solution. To see you through your goals, working 1:1 with Nicole requires at least a 4-month time, energy, and financial commitment. Cost includes all your specialty labs, full-access support, frequent follow-up visits, and hours of education which costs between $3000-4000 (spread out in a payment plan). Are you in a place where you can mentally, physically, and financially commit to reclaiming the best version of you? (Select one)You bet! Sign me up!Interested, but want more info about the financial commitmentInterested, but not sure I can commit the time to itWe do not accept insurance, but do accept FSA and HSA as forms of payment and can provide receipts, SuperBills, etc. for you to submit to your insurance.If you're unsure about the financial commitment of 1:1 work, are you open to group coaching? We do offer group coaching + lab work if you're looking for more personalization. Yes, group coaching sounds good. Would love group coaching + labs No, not looking for group coaching. Group coaching is offered 3-4 times per year.If you do not hear from us within 2 business days, please check your SPAM FOLDER!We reply to all inquiries whether it is to schedule a discovery call or refer to you another provider who may be a better fit! Submitting an application will automatically add you to the CFW newsletter mailing list. You can unsubscribe at any time. Looking forward to working together! PhoneThis field is for validation purposes and should be left unchanged.
