Natural Healing Interest Form

Thank you for your interest in natural healing with Lyme Disease. Please complete the following questionnaire and submit to Paula. Paula will contact you via email to confirm your free 30 minute coaching session. You and Paula will decide together if Paula’s coaching style is a fit for what you desire to achieve with your health and wellness. All questions must be answered to schedule a free 30 minute coaching session with Paula.

Name
FirstLast
Do you have a blood test confirming Lyme disease?*
Did you develop a bull’s eye rash?*
Do you know when and where you were bit by a tick (or other insect)?*
Are you now doctoring with a Primary Care Provider? *
Are you now doctoring with a Lyme Literate Doctor?*
Are you now doctoring with a Medical Naturopath Doctor?*
Are you now doctoring with a Traditional Naturopath?*
Have you followed the recommendations of your Primary Care Provider?*
Are you utilizing holistic therapies, like massage, acupuncture, energy healing, aromatherapy, herbal or homeopathic remedies?*
Physically, what has Lyme disease cost you?*
Emotionally, what has Lyme disease cost you?*
Mentally, what has Lyme disease cost you?*
Spiritually, what has Lyme disease cost you?*
Financially, what has Lyme disease cost you?*
Do you believe you can heal with Lyme disease?*
Do you believe whole food nutrition can help you heal?*
Are you ready to heal?*
Please provide 3 dates and times for Paula to call you. Paula will contact you via email to confirm a date and time. All questions must be answered to receive a call back for your free 30 minute coaching session.*
Best Email*

Body, Mind, Spirit Nutrition to Empower You. Protect to Prevent … Naturally.

Natural Healing Interest Form

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