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The Nourished Gut Application

I'm so glad you're here.
This short application helps me understand where you are in your health journey and whether we're a good fit to work together. There are no right or wrong answers — just be honest. It takes about 5 minutes.

What's your name?

What's your email address?

How did you hear about me?

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What's bringing you here? Check everything that applies.

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Tell me more about what's going on. How long have you been dealing with this, and how is it affecting your day-to-day life?

What have you already tried?

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What would life look and feel like if this was resolved? What's the outcome you're hoping for?

What's been the biggest thing stopping you from getting support until now?

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When are you looking to start?

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Working with me is an investment in your health. My programs typically range from $300-3,000 Are you in a position to make that investment if we're the right fit?

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Is there anything else you'd like me to know before we connect?