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Schedule your first 30 minutes free call

Full name

*

Email

*

Phone number

*

Date of birth

*

Now, choose your availability for our session.
Once it’s booked, you can continue filling out the form so I can get to know you better and personalize your experience.

What has brought you here?

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(You can talk about symptoms, life stages, intuition, curiosity… whatever feels right.)

What are your current health and wellness goals?

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Is there anything about your health that you’d like me to know?

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Do you currently take any medication or dietary supplements?

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Medical history:

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Medical diagnoses or current illnesses

History of serious illnesses, hospitalization, or surgeries

Hormonal imbalances (PCOS, amenorrhea...)

Physical Health

Height

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Weight

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Con cuales de estos adjetivos te sientes identificada al describir tus hábitos alimentarios actuales

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Con cuales de estos adjetivos te sientes identificada al describir tus hábitos alimentarios actuales

Anxious

Rigid

Impulsive

Disorganized

Balanced

Intuitive

Conscious

Restrictive

Guilty

Automatic

Allergies, intolerances...

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Is there anything you'd like to change about your nutrition?

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Mental Health

From 1 to 10 how would you rate your mental health at the moment?

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Why have you chosen this number?

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