Application to get started
Hi 👋 Congratulations on taking the next step in your health and growth journey! The fact that you are doing this means you are ready for real shifts and progress. I got you, so let's get started.

Please fill out the form to the best of your ability, it will be reviewed and I'll be in touch to schedule a time to connect.

Until then,

👩🏻‍⚕️ Dietitian Sandy
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Email *
What is you first and last name? *
Date of birth
Best number to call or text *
Have you worked with a Dietitian/Nutritionist before? *
Required
If so, who was it and for how long?
How did you hear about me? *
Where do you most often go to health information?   *
Referred by a Doctor or your insurance website? *
Please see the FAQ and insurance verification disclosures on my website. 
Required
On a scale of 1-10, how satisfied are you with your health?* *
Least Satistied
Extremely Satisfied
What specific results would you like to achieve in the next 30 days to 6 months? *
How important is that for you? *
Not Important
Very Important
What is your #1 single biggest challenge when it comes to weight loss, making behavior & lifestyle changes?     Please be as detailed and specific as possible. (Please go beyond saying "motivation" or something like that). The more specific and detailed you are, the more likely I'll be able to help. *
Why do you feel you are not making progress at this time? *
How do you feel about that?
How much would you say you have spent on your health (including diet programs, trainers, supplements, surgeries, lab work, etc.) in the last 3-5 years?* *
On a scale from 1 to 10, what is your level of motivation for making a change? 1 - not motivated at all and 10 being 100% motivated * *
Not Motivated
VERY Motivated
At this time, are you willing to invest in yourself emotionally, timewise and financially with my nutrition and lifestyle coaching Programs?* *
Any additional info you'd like me to know prior to reviewing your application? *
Thank you for taking the time to complete this questionnaire. I'll review your application and a member of our team will contact you with the next steps.                                                                         *
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Live + Life + Healthy
Acknowledgement
By submitting this application, you'll be added to the InVita Wellness Insider Newsletter
Don't worry I am not spammy 😉

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