Let’s work togetherApply to Find Food Peace now and book a discovery call!Find Food Peace Application Form: Name * First Name Last Name Email * Phone * (###) ### #### Date of Birth * MM DD YYYY How did you hear about me? Instagram YouTube Google Recommendation Other Why are you seeking my support? Binging/Emotional Eating/Chronic Overeating Body Image Both Other Please share more: What are your top three biggest struggles you'd like to work on? What attempts have you made in the past (programs or self-help) to work on these struggles? * What are you looking to achieve/improve by working with me? How many years have you been dieting to try and lose weight in any way, even on-and-off? * 1-5 6-10 10+ What have you tried other solutions before and other treatments and why do you feel it didn't work? Why do you think my program is right for you? Are you currently working with anyone else (dietitian, therapist etc)? Do you currently purge after your binges? Yes No My program was created to improve your mental, emotional and physical well being around food and your body image. Do you want to learn to eat for your wellbeing while still allowing yourself to enjoy food? Yes No If concerned about body weight or size, are you ready to work together to accept the weight or size you can maintain effortlessly without dieting? Yes No My weight/size does not concern me How ready are you to invest in and start a new program? I am not ready, I just want some info! I am very ready, let's do this! If you're not that ready, what is keeping you from being 100% ready? I offer flexible payment options to work with me and I require a three month commitment. If you're a good fit, are you ready to commit and get started? I am ready to invest in myself! Yes, I just need a payment plan (3 and 6 mo payment plans available) I am still trying to decide if this is right for me By submitting this form, you will be added to my mailing list. You may unsubscribe at any time I understand I can unsubscribe at any time Thank you!
