Hi, I'm Ashley!! It's great to meet you...

Tell me, What's Your Full Name? *

What's the Best Email Address where we can reach you? *

For support during the call, what's your Cell Phone Number? *

What's your Zip Code? *

Yes or No?

Would you be a new patient? *

Yes

For existing patients only, you are welcome to please contact the office directly at your next earliest convenience!

Fill Me In.

In a nutshell, what is your specific health complaint? *

Fill Me In.

Are you new to Functional Medicine? *

Yes

Fill Me In.

What other treatments or drs have you been to in the past 6 months? *

Fill Me In.

Considering your past treatments, what would you like to improve or do differently moving forward? *

Before we move on - I'd love to learn more about where you are now to see how I can help you get to where you want to go...

What are 2 or 3 things - health challenges - that you would like work on? *

Let Me Ask...

What service Best Describes your health needs right now?

1-to-1 Health Coaching

Case Audit/Analysis of Existing Labs

In-Depth Testing/ Work with the Dr.

Opportunities to Learn

Let Me Ask...

Are you preparing to make a decision about what direction to go in with your care?

Yes

Let Me Ask...

Have you ever been asked to pay for clinical expertise on your own? (Functional medicine, nutritional counseling, etc)

Yes

Let Me Ask...

Without knowing too many details about program pricing and lab costs, are you currently seeking professional guidance?

Yes

Let Me Ask...

Would it be helpful to have a supportive family member on the call before you decide?

Yes

Lastly...

Is there anything else that would be helpful to know right now ahead of our "First Step Success Call"?