NOTE: The information that will be given should not be construed as or replace medical advice.

 

First name *

Last name *

Your Email *

City / Town *

Province *

Country *

Mobile Number *

Skype Address *

Your Gender *

FemaleMale

Your Age

Do you have children?

0 – 5 years6 – 12 years13 – 18 yearsOlder

Who suffers from allergies?

Age of person?

Type of allergies?

How long has the allergy been a problem?

Do you have a Doctor that is treating this?

In short, what advice have they given to manage this?

Are you following this advice?

Are you taking the recommended supplements/medication if applicable?

What are your goals in terms of managing the allergy/ies?

Record a food diary for 3 days detailing everything that is eaten / drunk including spices, condiments, salt, sweeteners, tea etc. If it is a bought prepared item, please list the ingredients.

DAY 1

Breakfast

Snack

Lunch

Snack

Dinner

Snack

DAY 2

Breakfast

Snack

Lunch

Snack

Dinner

Snack

DAY 3

Breakfast

Snack

Lunch

Snack

Dinner

Snack

Sending us these pics helps us pick up on any foods that are not helpful that may not have been in the 3 day food diary.
Take a pic of the inside of your fridge and attach (Maximum upload file size: 2 MB)

Take a pic of the inside of your grocery cupboard and attach (Maximum upload file size: 2 MB)

Take a pic of the inside of your spice cupboard and attach (Maximum upload file size: 2 MB)

Do you need help in transforming lunch boxes to be fresh, healthy and nutrient dense to help your child thrive?

We will adventure together to work out delicious and fun lunch boxes that make for optimal nutrition, good brain functioning and healthy energy. You’ll be surprised by how many options there are and how much calmer and more focused your child can become.

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