Thriving with Stress and Anxiety: 6 Week Virtual Wellness Series 
Duration: 6 weeks, Begins April 3rd

Focus on:
Easy to follow whole food nutrition plan
Finding your ideal movement
Simple self care practices
Optimizing restorative sleep
Goal Setting
Online Resource Library
Weekly Yoga Library
Accountability/Support

Cost: $99

To sign up:
Please complete this registration form and you will be sent an invoice for payment.

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Name *
Email *
Age
Phone number
Please list your main health concerns:
Current Height and Weight
Would you like your weight to be different? If so, WHY?
Do you take any supplements or medications? Please list name, dosage and indication:
How is your Sleep?    How many hours per night?
Do you feel rested upon wakening?
Very Tired
Well Rested
Clear selection
How is your overall energy level?
Low Energy
High Energy
Clear selection
What role does exercise play in your life?
Food Info: Do you follow a certain diet or nutrition plan? If yes, what is it?
Please record what you eat in a typical day:  Breakfast, Lunch, Dinner, Snacks, Beverages
What is your current level of stress?
No stress
Stressed to the Max
Clear selection
What gives you the greatest joy in life?
GOALS: What do you hope to achieve by working with us?
What do you see as the main obstacles to achieving your health goals?
Is there anything else you would like to share about yourself in order for us to best support you?
Submit
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