Thanks so much for taking the time to apply for an Autoimmune Breakthrough Session with me. Please complete the application and email back to me. I’ll review it and determine if we seem like a good fit to work together. Your Name Email Address Phone Number What is your history in terms of dealing with autoimmune disease? What symptoms do you have, and when did these begin? What are the ways your life is impacted by these issues? How does this influence your daily life? What are your greatest fears about these health issues if things continue? What tests have you had run, or diagnoses given, up to this point? What type of practitioner have you seen for these issues? What treatments, protocols, cures, and approaches have you tried? What helped? What didn’t? Making significant and sustainable health changes can literally save your life (and certainly transform your quality of life!) And… it will take an investment of time, effort, and income to take on new practices and have the specialist support you need. Are you truly willing to commit to yourself in these ways? YesNo How important on a scale of 1-10 (with 10 being the most important and 1 being the least important) is it to you to address these issues now? YesNo
