New Client Application: Get on the Waitlist

Thanks for your interest in working with me! I’m not currently accepting new clients, but you can fill out the form below to be placed on the waiting list.

Please note that I offer coaching via phone and video for clients who are pursuing intuitive eating, Health at Every Size, and recovery from dieting or subclinical disordered eating. Virtual coaching is not appropriate for people struggling with active eating disorders, particularly anorexia, bulimia, or other eating disorders involving restriction or purging. If you do have an active eating disorder, please see the National Eating Disorders Association for referrals instead.

All information shared here is kept secure and confidential in compliance with U.S. privacy laws (HIPAA).

Name *
Name
Phone *
Phone
Please select the option that best describes your main goal for our work together:
What current health conditions are you experiencing? *
Please check all health conditions you've had in the past year:
Please list any additional health conditions you've had within the past year.
Please note any health conditions you've had in your life prior to the past year.
Current treatment team *
Please select any healthcare providers you currently see: