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  • Getting Started Questionnaire

    Please read through the following questions carefully and answer them as best you can. When you are done, hit submit and your information will be sent to Becky.
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  • *Please list your address, city, state, zip / postal code, country you reside in.
  • *Please list your child's top struggles, concerns and issues so that I may have a better understanding of what you may need immediate help with.

  • *Please list any therapies, nutritional changes or approaches here.

  • *Please list everything you and your family miss out on due to these issues.

  • *Please let me know how will life be different, what would you be doing, what are your dreams for your family and your child's future?

  • Should be Empty: