Sharon Cavanaugh
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    Bio-Individual Background Info Form

    Read this before you start!
    The more info you fill out, the more rich our Discovery Session and subsequent Strategy Session will be. Feel free to expand and explain a LOT. I read the form without judgement so as you are filling it in, replace any self-judgement with curiosity. 

    If you are filling this out over time, save your longer answers to a document as the website will NOT save them if you close or restart your computer.

    Once you hit submit you will see the page with the 5 Day Tracking Tool. That's how you'll know the submission was successful. Contact coaching@sharoncavanaugh.com if you have any issues or want to follow up to make sure I received it.

    All the information you share in this form and during sessions is confidential between you and me. If there is anything you'd rather speak about than write down, note that in the form. If you have any questions about what a question is asking, email me at coaching@sharoncavanaugh.com. 

    Five Cent Functional Nutrition Program Includes the Following:
    Step 1: Submit this form
    Step 2:  Sharon will send a follow up email with more clarifying questions
    Step 3: Complete a consecutive 5 day Food and Symptom Tracker in your own time and submit it to Sharon
    Step 4: Sharon will send a follow up email with more questions and ideas specific to your health journey
    Step 5: Send Sharon Five Cents and Feel Better as you are on your way to living as your most Vibrant Self (venmo: @Sharon-Cav PayPal: sharonface@gmail.com)

    Client Info


    Statistics


    History


    Health Concerns


    Nutrition Practices


    Intestinal Status


    Medical Status


    Health Hazards


    Oral Health History


    Lifestyle Stressors


    Sleep


    Sexual History


    Females Only


    Mental Health Status


    More important bits...almost finished!

    ​By checking the box below and typing my name, I agree to the Terms of Service.
    Save all your long answers to another document before clicking submit just in case the connection goes out or it doesn't process correctly.

    Once you hit submit you will see the page with the 5 Day Tracking Tool. That's how you'll know the submission was successful. Contact coaching@sharoncavanaugh.com if you have any issues.
Submit
Questions adapted from Andrea Nakayama's Functional Nutrition Lab.

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© 2023 Sharon Cavanaugh Zelement LLC 
  • Home
  • Coaching
    • New Clients
    • Coaching on Skis
  • Agreements
  • Resources
    • Online Courses
    • Monthly Support Calls
    • Newsletter Sign Up
    • Newsletter Archive
    • Bali
  • Payment