Health Survey | MAD INTUITION

Please describe your goals in working with me as thoroughly as possible.

What strategies have you tried, if any? (Include any diets, exercise programs, medical interventions, etc.) How long did you try them for? What did you like or dislike about them?

Describe a typical day for you--sleep habits, exercise routines, work schedules, etc. (Include any differences between weekdays and weekends.)

Any other important information I should know?

Informed Consent Form