Your Name (required)
Your Age (required)
Your Email (required)
How long have you been trying to conceive?
Steps you have already taken? (check all that apply) IVF?IUI?Clomid?Letrozole?Acupuncture?Natuopathic Medicine?Supplements?Counseling or Therapy?Other
Why do you want to work with me?
What are your goals? List 3
How much have you invested already in your fertility in the form of supplements, treatments, products, consults, IVF, etc.? (choose one) Nothing. The internetprovides me plenty of free advice and I don’t need an expert$100. I rarely buy anything unless I know the evidence behind it.$101-$500. I’ve dabbled with a few things here and there hoping they work.$501-$1000. I buy just about everything I hear about hoping it will help me too!$1000-$5000. I not only buy products and supplements but I’ve paid out of pocket for medical treatments (IUI, ultrasounds, acupuncture, herbs, etc.)>$5000. I’ve spent thousands on fertility treatments out of pocket