To Your Health! Nutrition
412 W. Olive St.
Fort Collins, Colorado 80521
Phone: (970) 224-2310

To Your Health Nutrition Process

The first appointment sets the tone and pace for our work together. By filling out and returning these nutrition client intake forms two to three days before our first meeting, I will be ready with a preliminary plan on day one. This saves time and money.

The first two forms (“Client Agreement and Release” and “Client Information”) are needed for every new client. If you have time, please fill out the “Diet Tracker” also. This can be brought into your first appointment if time is short or returned with the rest of the forms. These forms can be downloaded and printed out then faxed back to me. (Fax 970-224-2356) You can also scan them and email them to me. If you would like to fill these out on your computer and email them, then please contact me and I will send them in a Word format.

The “Progress Questionnaire” is for you to fill out before each of your follow-up appointments. This can be faxed or emailed back to me or brought into your appointment.

Nutrition Forms



Nutrition Therapy Disclaimer

Nutrition Counseling is not intended as a diagnosis, treatment, prescription, or cure for any disease, mental or physical, and is not intended as a substitute for regular medical care.
Nutrition Counseling does provide nutritional evaluation, balanced diet planning, nutritional supplement suggestions, and lifestyle recommendations for the purpose of enhancing health.

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