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Support Group Questionnaire

Functional Nutrition Counseling can heal many health conditions. Please indicate what illness categories are of most interest to you.
Please indicate what types of educational support group in each of the different lifestyle categories that you are interested in. 

1. Non negotiables for healing diet (elimination of the top three most inflammatory foods in western diet)

sugar
gluten
dairy

From a scale of 1-3 please list which groups you are interested in each lifestyle section.

DIET

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SLEEP

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MOVEMENT

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SOCIAL SUPPORT/NETWORKS

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STRESS & RESILIENCE

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MIND/BODY/SPIRIT

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REDUCING TOXIC LOAD

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Are you interested in being contacted about a support group to help you modify your diet and lifestyle for greater health?

Thanks for submitting!

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