Schedule a Discovery CallFill out the form below to schedule your discovery call First Name * Last Name * Email * Phone * What is your main health complaint? * How often does it bother you? * Everyday Once per week 2 to 3 times per week Once per month How long has it been going on? * 1-6 months 1-3 years Over 3 years What (or who) would prevent you from completing a health-rebuilding or weight loss program? * Children Spouce Time Self Money Resources Job Fear What have you tried so far that has or has not worked? * What is your current diet like? Please be specific: list breakfast, lunch, dinner and snacks, as well as the times you eat. * Are you taking any supplements or medications? Please list what you take and what it’s for. * What would you like your health to be in 3 months from now? How about 6 months from now? * What obstacles, challenges, and struggles do you face regarding diet/lifestyle? * If we were to work together what would you expect to achieve from working with me? * What are 5 things you LOVE about your life? * Yes! I want to get awesome health tips, tools and resources Submit Your privacy matters!Your information will be kept private, because that’s how it should be
Dr. Riley SmithDr. Riley Smith