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Please answer the following questions so I can prepare for our appointment.
First Name
E-mail (please use the same e-mail you used for booking your appointment)
Last Name
Phone
Occupation
How did you hear about Wander Woman Wellness (Lisa Strylowski)?
Website
Internet
Webinar/Workshop
Facebook
Instagram
Podcast
Referral
Other
What symptoms are you currently experiencing? Check all that apply.
Irregular, heavy, or absent periods
PMS or PMDD
Hair loss or abnormal hair growth
Weight gain or loss
Mood swings, anxiety, or depression
Fatigue
Brain Fog
Digestive Issues
Insomnia
Low libido
Skin Issues
Headaches/Migraines
PCOS, Endometriosis, Thyroid Disorders, or Blood Sugar/Insulin Disorders
How are these affecting your professional success?
How are these affecting your personal life?
How would healing your hormones and being able to trust your intuition again change your life?
What have you tried in the past to heal your hormone imbalances? (please include all medications, herbs, supplements, therapies, lifestyle modifications, nutrition etc)
Why is now the right time for you to invest in your healing?
*
Because I deserve to feel truly well, and I know my abilites as a healer are only as powerful as the self-healing work I've done.
I know that not by not prioritizing my healing, things will continue feeling this way, and I'm sick of the struggle.
I'm not really sure, but I'd like to know more.
Do you promise to honor the values of fair energy exchange by showing up for your scheduled appointment ON TIME and DISTRACTION FREE? Please confirm by typing "Yes I Will" below.
Send me e-mail updates & important news.
Submit
Thank you! I look forward to meeting you!
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