Application to Become a Client of Lauren Zajac
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First Name *
Last Name *
Phone Number *
Email Address *
Birth Date *
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Gender *
Occupation *
How did you hear about my services? If you were referred, please name them so they are sincerely thanked. *
What are your top health goals in the next 6 months? Please be specific. *
As a concierge health consultant, I work with clients to fine tune (and sometimes completely overhaul) their mental, physical, and environmental well-being. My unique multifaceted and comprehensive approach leaves no stone unturned. It restores clients to their true health, which enables them to feel their best, perform at their highest ability, and enjoy life all in unison.  You must be open to learning and implementing new concepts, some very different from what have been ingrained in us through traditional societal and medical norms. If you’ve never dedicated 6 months to fully prioritizing your health, then you have no idea how incredible you can feel and how you will inevitably flourish in all aspects of your life. Your emergence will be infectious to all those around you and will likely empower some of them to do the same. Now is the time to make yourself THE priority. You (and your family) deserve having you show up as the best version of yourself.
If you could erase 3 health related problems from your life, what would they be? Please be specific. *
What has been your biggest barrier/struggle to achieving these goals? *
What (or who) in your life has been negatively impacted by your current health status? *
What are you MOST excited about happening when in 6 months from now you are feeling, looking, and performing better than you ever have? *
Are there any life goals you desire to achieve in the next year that are not health centered? *
Are there any life goals you desire to achieve in the next year that are not health centered? *
Are there any life goals you desire to achieve in the next year that are not health centered? *
There is a 4 figure investment for my completely customized 6 month transformational program. I only accept an exclusive number of clients per year to ensure I can give my full attention towards helping them to achieve their health (and inevitably non-health) goals. Are you mentally and financially ready to commit to your health in this way? *
There are multiple financial entry points to work with me. Please choose the amount you are willing to spend to transform your life and health at this time? *
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