MM Wellness New Client Questionnaire
Meagan Maritato, MS, RDN, CD, NASM-CPT
Why are you interested in working with MM Wellness?
Please indicate which MM Wellness program(s) you are interested in:
Intuitive Eating Counseling
Body Image and Body Kindness Coaching
If you are inquiring about corporate wellness programs, grocery store tours, and/or group classes, please exit this form and contact Meagan via email at firstname.lastname@example.org
What are your current health and wellness goals? Please describe below:
Tell me your "why"? Why are these your current goals?
What do you believe your biggest challenges are that are preventing you from reaching your goals right now?
How would you rate your readiness to make changes and achieve these goals, on a scale from 1-5?
1 = I have not thought about making changes to achieve my health goals and I am not ready to
2 = I have thought about making changes, but I am unsure if I am ready to
3 = I am somewhat ready to make changes
4 = I am 100% ready to make changes today
5 = I need support maintaining the changes I have already made
Are you currently ready to make a financial investment to join a nutrition coaching program?
Not at this time
My monthly budget for nutrition coaching is:
*This will provide me with an idea of a program starting point for you!
Please verify that you are human
Initial Consultation Call Appointment Request
Please request an appointment time using the calendar below. Discovery calls are booked in 30-minute time slots. *If you do not request a time, I will reach out to you to schedule a time to meet.
Request a time for a call:
Should be Empty: