YES! I want to discover and resolve the root cause of my health issue! Here's my application...

YES! I want to discover and resolve the root cause of my health issue! Here's what I understand so far about my situation...
The first step in me helping you is to gain some essential background.

The 5 minutes it will take you to answer a few questions will speed up our time together when you book your complimentary call.

Rest assured all details are completely confidential and for my eyes only.

Many thanks.

Kim
Personal Details
Name *

First Name Last Name
Occupation *
How did you hear of Kim Knight Health? *
Phone Number (I will only call you at a pre-arranged time)

Area Code Phone Number
E-mail (so I can reply to this communication) *
Country / Time zone *
Age *

Your Situation
Tell me about the health issue you would like help with? If you have a diagnosis please put it here. *
Please list the main symptoms which are bothering you *
Complete the following statement: "I haven't felt well since..." or "things haven't been right since"... *
How is your life currently limited as a result of what you are experiencing? *
What would your life look like if this issue was resolved? *
What other healthcare approaches have you already tried and what difference have they made? Please list both conventional and natural solutions you have tried *

Investment

Giving me an honest estimate of how much you are able to invest in yourself helps me to determine which of my services (1-1 coaching or online self-help programs) will best suit you.
My budget for investing in a health program which will create positive lasting change for the rest of my life *

$500-$1000 USD $1000-$3000 USD $3000-$5000 USD

How ready are you to get started?

In 25 years of coaching and exploring chronic illness recovery there is one thing which will determine your outcome: your readiness to commit and get started. Please indicate your readiness for explorations into a new way of being (guided safely and expertly so there is no need to be worried!).
How ready are you for a different and better outcome? *

I'm absolutely ready to get started. I can see you know what you're talking about and I like the fact you look at health in a holistic way. I am starting to understand how stress, emotions, trauma and lifestyle play a big part in illness. I'm unsure, I'm just checking out a few options I'm not yet feeling ready

Anything Else?
Is there anything else you'd like to mention?
Many thanks! I will review your information and get back to you with details to schedule a short introductory call so that we can meet to answer any initial questions you may have, and I'll explain how we can work together.

In the meantime, feel free to check out my blog or join me on facebook.

Cheers! Kim
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YES! I want to discover and resolve the root cause of my health issue! Here's what I understand so far about my situation...