Halfway Revisit Form Date * MM DD YYYY Name * First Name Last Name What overall positive changes in your health and well-being have you noticed since starting your 6-month program? * What goals have been met? * Are there areas you would like to focus on, shift, or approach differently in order to meet your goals? * What recommendations did you find helpful and which do you continue to use? * Please list any people in your life you think could also benefit from work like this: * What is your main concern at this time? * Any other comments? * Any changes with weight? * How is your sleep? * Constipation or diarrhea? * How is your mood? * Are you exercising? * What foods do you crave and when? * What percentage of your foods do you cook/prepare at home? * 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% What’s your diet like these days? Breakfast * Lunch * Dinner * Snacks * Liquids * Any other comments? * Any questions about foods or ideas introduced so far? * Thank you and congratulations on taking your first step towards balance. I will get back to you shortly!Onwards & Upwards,Carolina R. Marrelli, I.N.H.C.
