LET'S WORK TOGETHER

Name

In a few words, what is the primary reason you would like your child to see Dr. Schneider?

What are you hoping to get out of working together?

If you could change 3 things about your/your child’s life what would they be?

Is there anything you/your child struggle with or find difficult?

What's going to be the biggest challenge or obstacle to your/your child’s success?

What other personal development / coaching / therapy have you/your child done in the past?

Is there anything you'd like me to be aware of?

How committed are you right now to improving your/your child’s health?

Please indicate where you are financially and mentally in your ability to invest in health coaching and guidance to help you get healthy.