Name

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Phone

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Your Phone Number

Your Email Address

Add me as a Facebook contact at my profile address here: https://www.facebook.com/profile.php?id=1003332956

1. What are your primary complaints from the following: inability to lose weight/gain muscle, gas, bloating, constipation, diarrhea, inability to focus, anxiety, low sex drive, low energy, hyperactivity, insomnia, lack of motivation to do things you enjoy, depression, PMS? *

2. What are your primary goals? *

3. Are you currently following a nutrition and exercise plan? If so, what are you doing? If following an exercise plan, how many days per week are you exercising, and how long are the sessions? *

4. How committed are you to maximizing your metabolism through a full lifestyle change? How do your symptoms/your situation make you feel? *

Please check the "I AGREE" button for each statement if you agree.

5. Which programs are you most interested in?

Labwork Interpretation & Custom DRESS Plan

"Take It and Go" Metabolic Reset

Maximum Metabolism Reset

Maximum Metabolism Damage Repair Program

Maximum Metabolism Membership

Maximum Metabolism Membership for Students

12-Week Competition/Tournament/Fight Prep

8-Week Competition/Tournament/Fight Prep

Courtney can run every necessary lab test on you, get the results, write out an intricate plan for you, and guide you through the whole process with ease. However, it is YOUR responsibility to follow that plan to a ‘T.’ Should you not see results you want with your plan, you will not place blame on Courtney as the Practitioner, as there are likely deeper issues that need addressing that we may not have tested yet, or that cannot be seen in a lab test.

I AGREE

You also understand that if you choose not to run all the recommended lab tests (i.e. due to a limited budget) and are not seeing the changes you want, that you will not place blame on Courtney as the Practitioner. In this scenario, the likely cause of not seeing the preferred changes is due to not having performed all the recommended lab tests.

I AGREE

Courtney does not work with individuals that consistently display they are not following their plan. Mistakes will happen occasionally, and that is understood. Not following the plan is a waste of the client’s money as well as Courtney’s time. I understand that if I choose to work with Courtney, that I will go forth with my efforts consistently and with integrity.

I AGREE

Thank you for completing this form as it helps me to accomplish two things. First, it helps me to understand your situation so that I can best support you. Second, by agreeing to the items above, you also understand how best to get the most out of working together! Let's do this!

Click the button below now that you're ready!

If you are human, leave this field blank.

Work With Me

Please check the "I AGREE" button for each statement if you agree.

Thank you for completing this form as it helps me to accomplish two things. First, it helps me to understand your situation so that I can best support you. Second, by agreeing to the items above, you also understand how best to get the most out of working together! Let's do this!

Click the button below now that you're ready!

Reclaiming your health starts here...