Michael is available for a consultation to discuss your individual health and fitness concerns and suggest a course of action. Consultations can be in person, by phone or Skype

Email to Michael the following information at . Michael will contact you with available times to talk.

Name:                                                 Date:                                         Age:



Phone Number:

How did you find me:

Availability for the consultation (days / times of day):

1. What’s your main complaint?

2. How often does it bother you?

3. How long has it been going on?

4. What have you tried so far that has not worked?

5. What does it prevent you from doing or enjoying?

6. Is there anything in the way of you getting healthier?

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