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 fill in this form will be invaluable and enable me to know our next best step.

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

Here's to your transformation! :)

Kim
Personal Details
Name *

First Name Last Name
Occupation *
How did you hear of Kim Knight Health? *
Phone Number (I will only call you if you decide you would like a chat - we will arrange a time by email before I call)

- 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 *
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 approaches or therapies have you already tried and what difference have they made? *

Do you know the average human life is valued by insurance companies at $9 million? Often we can value our house, car and home contents, and forget to value our health (which is, by the way, one of the reasons we get sick)...
Coaching with Kim is a transformational experience. Are you ready to invest in yourself? *

Yes absolutely I'm ready to feel better Not really I'm just researching options It depends, I need to know more
How much are you willing to invest in yourself to turn this situation around? (This helps me know which online program or private coaching package to recommend) *

0-$500 $500-$1000 $1000-$3000 $3000-$6000 $6000-$10,000 $10,000+
Is there anything else I should know?
Thank you for taking the time to fill this out! I will review your information and get back to you with details to schedule a 10-minute intro call with me.

In the meantime, feel free to check out my blog or 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...