* 1. How physically healthy are you?

* 2. How important is exercise to you?

* 3. Do you feel you get too much exercise, too little exercise, or about the right amount of exercise?

* 4. In a typical week, how many times do you exercise?

* 5. In a typical day, how many of your meals or snacks include fresh or frozen vegetables?

* 6. In a typical day, how many of your meals or snacks include animal protein?

* 7. In a typical day, how many of your meals or snacks include vegetables?

* 8. In a typical day, how many of your meals or snacks include fruit?

* 9. What is the best way to contact you? Enter contact information below

* 10. Dalia Kinsey is not a physician or psychologist, and the scope of her consultation services does not include treatment or diagnosis of specific illnesses or disorders. If you, the client, suspect you may have an ailment or illness that may require medical attention, then you are encouraged to consult with a licensed physician without delay. Rather than dealing with treatment of disease, Dalia Kinsey's coaching focuses on wellness and prevention of illness through the use of natural nutritional therapies to achieve optimal health. As a certified wellness coach and nutritionist, Dalia Kinsey primarily educates and motivates clients to assume more personal responsibility for their health by adopting a healthy attitude, lifestyle, and diet.While people generally experience greater health and wellness as a result of embracing a healthier attitude, lifestyle, and diet, Dalia Kinsey does not promise or guarantee protection from future illness.

Do acknowledge that you understand that Dalia Kinsey is a wellness coach and will not be held liable for failure to diagnose or treat an illness (nor will she be liable for failure to prevent future illness) and that you should see a doctor if you think you have a medical condition?

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