Get Started - Simply Nathalia

I will walk you through every aspect of diet, exercise, and lifestyle choices – created specifically for you.

STEP ONE:

Fill out Application (Below)

Be honest and detailed.

The more I know, the faster you’ll see changes.

STEP TWO:

Schedule a Skype Consultation

Are we a good fit?

After I review your application we will schedule a video chat.

STEP 3:

Begin Your New Life!

Let's start changing!

Welcome to the first day of a healthier, happier you.

Interested in working together? Tell me about yourself.

Name: *

Email: *

Confirm Email: *

Telephone: *

Date of Birth: *

Height: *

Current Weight: *

Why is it so important for you to reach your goals? *

How much weight do you wish to lose or gain? *

How much time are you willing to dedicate to reaching your goal? *

In which country do you reside? (This makes a significant difference in selections and portions of foods.) *

Do you have children? If so, what are their ages? *

Are you allergic to any foods? Are there any foods that you don't eat at all? What are your favorite foods? *

Describe your meals on an average day and the times you have them. (I know every day is different, but try to give an overall idea of what you do on a regular basis.) Describe everything: sweets, drinks, alcohol, etc. The more details the better. *

Describe what a regular day in your life is like (what time you wake up, what time you go and come from work, what times you work out, etc.). *

How many hours do you sleep every night? *

Have you ever undergone surgery? *

Do you take any medications? Vitamin supplements? *

Do you have high blood pressure? *

Have you or anyone in your family ever had a heart attack? *

Do you have any orthopedic problems? If so, what do you have? *

What is your favorite physical activity? Indoors? Outdoors? *

What is your weekly availability to practice physical activity? *

Do you believe you are determined? A fast quitter? *

How aggressive do you want to approach your diet? *

Extremely Aggressively
Aggressively
Moderately
Slowly

Is there anything not asked in this questionnaire that is important for me to know?