
Welcome!
Below are the intake forms that need to be completed and sent in 24 hours prior to your first appointment to melanie@honestbody.com
It’s a bit of paperwork on the front end, but bear with the process…its important to our work together.The more I know about you, the better I am able to help you.
One form at a time
Form 1: Food Journal
Please use this form for 5 days of food journaling. You can either print it out and write in it, or save your own copy to type in.
- Food journal – DOWNLOAD HERE
Form 2: Health History
This is the basic health history form that we’ll use to go more in depth during your first consultation.
- Men’s – DOWNLOAD HERE
- Women’s – FILL OUT HERE
- Child’s – DOWNLOAD HERE
Form 3: Emotional Questionnaire
Emotions have a significant effect on our health. This form gives us some insight into your emotional health.
- Emotional questionnaire – DOWNLOAD HERE
Form 4: Informed Consent Disclaimer
Please sign and date at the bottom.
- Informed Consent – DOWNLOAD HERE
Form 5: Fee Schedule
Please fill out this form.
- Credit Card Authorization & Fee Schedule – DOWNLOAD HERE
Resources
Here is a list of recommended books & a printable workbook:
- The Gut and Psychology Syndrome (foundational to all GAPS work)
- The Heal Your Gut Cookbook (includes recipes for each stage of Intro!)
- GAPS Stories (for times when you need encouragement, or for a rainy day)
- Printable GAPS Workbook (for tracking your progress & other things)
Lastly:
Keep an eye on your email inbox as I will be sending you an invitation to take the Nutri-Q Symptom Burden Questionnaire.