Consultation/Coaching Request

I have not failed. I have just found 10,000 things that do not work.

By agreeing to this consultation, you acknowledge that I am not medically qualified and that all the information I provide is from research and is intended to help you to make informed choices to support your own research further. Any information given in this consultation should not be seen as medical advice.

It is not intended as a substitute for treatment or advice given by your own doctor, or any other medical professional involved in your care.

Consultation/Coaching Request Form

I have read and agree to the above terms of consultation*

Yes

If you do not have/know any of the information requested, please write not known/none, so that I know that the question has not been missed.

Full medical name of diagnosis. Please don't write lung or breast cancer as there are different types.

Any metastases to lymph nodes, bones, or other organs?

Any known mutations from biopsy or genetic testing? For example, BRAF or BRCA?

Any treatment currently being received and the cycle? Please provide drug names.

Are you on any blood thinners? If so, please provide details.

Any medicinal allergies?

A full list of supplements and medication currently taken and the doses. Please also include anything that was prescribed prior to diagnosis for any other conditions.

Are you suffering with any treatment related side effects or conditions needing support? This could be ascites, cachexia, constipation, appetite loss, low platelets, bone pain.

The consultation can exclude or include a video. With either option a personalised protocol will be prepared and sent by email and follow up questions by email up to 7 days post consultation.

Please include any recent blood results if you have high/low readings and would like suggested supports. If bloods are all normal these is no need to include the results.

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Always Hope

Consultation/Coaching Request

Consultation/Coaching Request

I have not failed. I have just found 10,000 things that do not work.

Consultation/Coaching Request Form

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