Nutritional Therapy Application to Schedule a Clarity Call with Pamela Otero, NTP
IMPORTANT NOTE: It should take 5 minutes to complete and submit this application to schedule a Clarity Call. 

Once you submit this application I'll reach out to you within 48 hours via email and let you know if scheduling a 30-minute Clarity Call will be our next best step.  If for some reason you do not hear back from me within that timeframe please contact me at pamela@pamelaotero.com 

Please ensure you have time to complete this form in its entirety, as your answers will NOT be saved if you should need to finish completing it at a later time.

***PLEASE KNOW there is a $25 fee to schedule a 30-minute Clarity Call with me and it will be applied toward your Nutritional Therapy package if we decide to work together after the call. I require this small fee because I'm interested in working with women who are seriously ready to take the next steps toward resolving their chronic health issues and are willing to invest in their healing. That investment begins here.***
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Email *
What is your full name (First and Last)? *
What is the BEST email to connect with you at? *
What is the BEST phone number to reach you, if needed? *
What are your health issues/concerns? *
How long have you been experiencing these health issues/concerns? *
Required
What, if any, diagnosis have you received? *
Have you ever worked with a functional, holistic practitioner? If so, which ones.
 *
Are you familiar with Nutritional Therapy and/or Functional Holistic Nutrition?
 *
Tell me more about yourself. Why are you interested in potentially working with me? *
What is your vision of health and wellness for yourself?
 *
On a scale of 1-10, how much do the health issues, health concerns, and/or diagnosis you mentioned above interfere with your daily activities and life?
 *
Not at all.
Every day.
On a scale of 1-10, how willing are you to make the necessary dietary, nutritional supplement, and lifestyle changes to progress towards your vision of health and wellness?
 *
Not willing.
I'm 100% committed to do whatever it takes!
What is your time zone? *
How were you referred to me? *
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