1-on-1 Private Client
Application Form

Wholly Well 1-on-1 Private Client Application Form

Name

Phone Number

Age

In the next 3 months what changes would you like to make to your health? Please be specific.

What have you struggled with most/what has gotten in the way of achieving these goals?

If you could take away 3 symptoms or health complications in your life, what would they be?

So far in your health journey, what have you tried to fix your symptoms/imbalances?

The investment to work together in a high-level 1:1 relationship is a minimum of 4 figures and requires a minimum of two hours of training/work/implementation per week. Are you able and willing to make both the time and monetary investment in yourself?

1-on-1 Private ClientApplication Form

Wholly Well 1-on-1 Private Client Application Form

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1-on-1 Private Client
Application Form