Nutrition & Health Evaluation

 

 

         

 

 
 
 
 

NEW IN 2008:  Receive a FREE Nutrition & Health Evaluation with a purchase of $40.00 at Wholesale Cost from my source for health products, which qualifies you for free membership, and future purchases at wholesale cost.  Otherwise, please pay $35.00 for a Nutrition & Health Evaluation (below).  In either case, this includes preparation and emailing your evaluation, and if you are in the US, a phone consultation.

TO RECEIVE A FREE NUTRITION EVALUATION WITH PURCHASE: Either go to this link and shop for $40.00 in product at wholesale cost, or click here and complete the online form.  When you complete the form, products will be suggested based upon your results.  You can then decide which products you would like to purchase from those recommended, feel free to email me if you have questions about the suggested products.  AFTER YOU HAVE PLACED YOUR ORDER, please complete the form below, and send...read the instructions for completing the form carefully before completing.  In the "Additional Questions and Comments" box, remind me that you have made an online purchase.

Thank you for your interest in my Nutrition & Health Evaluation.  I have been helping people find health through nutrition for over 20 years, and received my CN designation (Certified Nutritionist) after completing a 2+ year course of study through American Health Science University after attending college.   This course of study was a balance of both traditional and alternative approaches to improving health, my strength and love being the alternative approach. I have also learned through working with those knowledgeable in the use of medicinal herbs and supplements, and by attending seminars and continuing education courses.  I am looking forward to helping you!

When the form is completed and payment, or the purchase described above has been made, I will evaluate the information you send me.  I will email or call you if I have further questions.  There is no extra charge for follow-up questions.  When all is completed, I will send your results attached to an email in "WORD" or "PDF" format. 

1.  If you ARE taking advantage of the offer to purchase the health products described at the top of this page, SKIP THIS STEP.  If you ARE NOT making a purchase, and are just paying for an evaluation, please pay for your Nutrition & Health Evaluation by credit card or through your paypal account using the PayPal "Pay Now" button below.  You do not have to be a PayPal member to make payment using this method.  There is a money-back guarantee within 30 days of your payment date if you are not satisfied.  If you pay with a credit card, your refund will be credited to your credit card account.  Please bookmark this page in the unlikely chance that you are not re-directed properly. You are welcome to complete the form before making your qualifying purchase or payment, but I will await your payment before reviewing the results. Thank you!

2. READ CAREFULLY - Please complete the form below, and click on "Submit" when your are ready to send.  Review your answers on the page that will follow, then click "continue".  As soon as you click "continue" the information you have provided will be on it's way to me.  I will send an acknowledgement to you when I receive it.   

PLEASE DO NOT use back button or leave this page during the process of completing the form, sometimes all information in the blanks is lost if you do this. 

If you would prefer, I can send the following questions to you in a WORD document, or in the form of an email.  You can save the WORD document to your computer, and answer the questions at your leisure, saving as you go...or answer the questions in the body of an email and save as a draft, so you can take your time answering.  Then when finished, you can email the document back to me as an attachment, or send me the email with your responses in the body of the email..  Send me an email after making your purchase or payment if you would prefer that I send you the questions in email or "WORD" document form.
 

   

 

Your name:

Email address:

Phone Number:

State or Time Zone:

BREAKFAST - List what you typically eat and drink:

                  Mid-Morning - List what you typically eat/drink:                      

Lunch - List what you tyically eat/drink:

Mid-Afternoon - List what you typically eat/drink:

 

DINNER - List what you typically eat/drink:

BEDTIME - If you have a bedtime-snack, list here:

SUPPLEMENTS - List any vitamins, herbs, etc. here

MEDICATIONS - List any medications you are taking:

Do you Smoke and/or Drink Alcohol, if so, what & how often?

ANTIBIOTICS - How often have you needed them in the past year?

Common or Chronic Ailments:

  Any health issue you are dealing with now, or deal with on a regular basis.

WOMEN, Do you take birth control pills?

 

Kindly provide your Height & Weight:

Do you Exercise, if so how, and how often?

Any Additional Information, Questions, Comments:

 

   

 

 
Nutritional & Health Evaluation prepared and provided by
Claudia L. Meydrech, CN
 
Certified by America Health Science University
 
 
Disclaimer:  I am not a doctor, and do not prescribe or diagnose.  You are responsible for the information you provide, what you do with the information you will receive in response, and for the outcome.

Copyright 1999-2008 Claudia L. Meydrech, CN

Updated 4/16/08