Are you ready? Tell me more about yourself.

In this comprehensive client information sheet, I will ask you to provide relevant information about yourself. Your answers are essential to allow me to design an optimized individual program for you. Please answer all questions in the most accurate manner possible while being concise.

Disclaimer of Liability - Please recognize that it is your responsibility to work directly with your physician before, during and after seeking a fitness and nutritional consultation. As such, any information provided is not to be followed without prior approval of your physician. If you choose to use the information without prior consent, you are agreeing to accept full responsibility for your decision. 
Name *
Name
Goals
In the list below, please check which goal(s) are your primary focus.
If there is any other information you think might be relevant to your program design, please share it with me. The more information you provide, the better I can develop a plan to help you reach your goals.
All the fun legal stuff
By checking this box, you acknowledge that you have read and understand the information provided by Lisa Desilet, MS in the Disclaimer of Liability and Acknowledgement. *
Acknowledgement *
Acknowledgement
By signing below, you acknowledge that you understand that Lisa Desilet, MS is a health consultant and not a physician and that you should see a doctor if you think you have a medical condition. Lisa Desilet, MS will not be held liable for failure to diagnose or treat an illness, nor will she be liable for failure to prevent future illness. Additionally, you promise to give Lisa Desilet, MS a complete and accurate account of any medical conditions that you may have and any medications that you are taking.

Once I receive your new client interest form and payment, I will send you more information to get started. New client interests received without verified payment will remain unprocessed until payment is confirmed.

Have questions? Send me an email anytime.

lisa@lisadesilet.com