Contact

I am so honored that you’re considering working with me! Please use this form below to request an appointment for nutrition counseling, or to reach out to me with any questions, concerns, or other inquiries. All information is confidential. I will get back to you as soon as possible. I am currently not taking new clients at this time. Sign up for my waitlist to be the first to know when i’m taking on new clients!

Please complete the form below.

Name

First Name

Last Name

Email

Phone

(###)

###

####

Where are you located?

This is to ensure I am licensed where you are located and able to provide nutrition counseling.

How can I help?

If you are looking to work with me for nutrition counseling please briefly describe why you're seeking nutrition counseling for yourself or a loved one.

Please indicate your availability for appointments

I see clients consistently every 1-2 weeks, usually the same day and time each week. Please list your availability for an appointment (For example, Mondays from 12:00pm - 3:00 pm, Tuesday evenings from 5:00 pm-8:00pm, etc.).

What payment method would you like to use?

Private Pay

Health Insurance

If you would like to use your health insurance benefits what health insurance do you have?

Would you like to sign up for my email list to receive the latest group program dates, special offers, and more?

Yes

No thanks

How did you hear about Renourishing Roots?

Please contact me directly via email if you have trouble filling out the contact form. Thank you!

Email: Crystal@renourishingroots.com