Your Name (required)

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Please check off the issues that pertain to you:

HeadachesInsomniaSinus ProblemsHives, Rashes, Dry Skin, AcneHot FlashesAsthma, BronchitisDiarrhea / ConstipationBloated FeelingHeartburnPain or Aches in Joints/MusclesArthritisBinge Eating/DrinkingFood CravingsExcessive WeightUnderweightEmotional EatingFatigue, Sluggishness, Low EnergyPoor Memory / ConcentrationAnxiety, Fear, NervousnessAnger, IrritabilityDepressionFrequent Illness

On a scale of 1-10, one being the least, please rate the following:
It's important for me to feel great and be the best I can be. 12345678910
I am interested in improving my health and energy. 12345678910
I am ready to commit to achieving my weight goals. 12345678910
I am willing to invest time and money in myself. 12345678910

Now you can do two things. One is to take action yourself to solve your most pressing health challenges. Identifying them and your commitment is a good first step to a workable solution.

Or, you can press SUBMIT, and it instantly becomes an application for a private 17-minute weight and energy exploration session with me so you can get to where you want to go—faster.

Your bonus for sending your Snapshot: I’m thrilled to send you the fabulous, must-have tip sheet from Mindless Eating, by Brian Wainsink.