New Applicant Information

NEW PARTICIPANTS: I'll need your name, address, email & phone # here...

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* 1. Contact Info

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* 2. By filling out this form, I agree to participate in a consultation with Small Hinges LLC’s founder Lindsay O'Neill, as a culinary medicine chef and wellness coach, to help me live a stress-less, healthier, and happier life. I understand that Lindsay is not a medical professional, and will follow her advice with my health, allergies, medication, injuries, and wellbeing in mind. I will not hold Lindsay or any participating "experts" liable for any recipes shared, advice or supplements recommended, that negatively impact or hurt me and/or my family. No refunds, discount no exchanges shall be given for any reason. This plan is customized specifically for me, and I promise not to copy, share or encourage others to do MY plan. I am solely responsible for the result of implementing the teachings from this consultation and ongoing plan in my own life.

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* 3. Health & Wellness

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* 4. Dietary Restrictions & Allergies

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* 5. YOUR favorite foods (list EVERYTHING you love to eat - breakfast, lunch, snack, dinner, dessert, drink)

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* 6. YOUR LEAST favorite foods (list everything you WILL NOT eat):

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* 7. What is your daily schedule? (both weekdays/weekends)

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* 8. Exercise - Please tell me about your exercise program (if you have one). Do you walk to work? Run? Play sports? How often? etc.

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* 9. How many alcoholic beverages per week (on average) and what kind of alcohol?

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* 10. What do you want to achieve?

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