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Submitted by admin on Thu, 09/29/2011 - 11:00pm

Welcome!

In order to make your time with us as productive as possible, we would like to have you complete some paperwork, previous to your visit. This will allow us ample time to revue your history, and keep your wait time in our office to a minimum.

Please fill out forms to the best of your ability, remembering that in this case, more is better. If there is anything we fail to cover, or something you’d like to expand upon, please feel free to write it in on the margins or turn over the page.

Include copies of all tests done in the last two years, as well as last bloodwork results, even if older than two years. As well, if you are taking any supplements, you may want to bring those in with you so we can go over them.

We look forward to seeing you soon! Thank you,

Nutrition Patient Forms

Form Set File
New Female Patient
application/pdf iconNewFemalePatientFormDS.pdf
New Male Patient
application/pdf iconNewMalePatientFormDS.pdf

Airlines spent over $275 million dollars a year on an additional 350 million gallons of fuel to support the extra weight of passengers in 1995.  That cost has gone up exponentially!

-- CDC

“Dr. Pete’s Boot Camp is the best gift I have ever given myself!  If you want to really change your life…DO IT!  I’m sad the class had to end… What’s next?”

The incidence of obesity in infants under 6 months has risen over 73% since 1980.

-- Harvard School of Public Health

"I would tell people, ‘If you are REALLY ready to change your life for the better…DO THIS COURSE!  It’s not for the faint of heart…but you will meet with success’”

America is the fattest nation on earth! 

-- CDC

 

“We had no idea just how stuck we were in our life.  This course has opened out eyes to so much more possibility.  We really feel alive again!”

86% of Americans will be overweight or obese by 2030

-- Johns Hopkins Bloomberg School of Public Health

“I feel as though I’m a better person!  My state of being, (mind, body and spirit) is healthier.  I feel that my life is sitting on a launching pad about to take off!”

“I now have more energy!  I have a better idea of what my priorities should be and have a plan to execute them.  I feel alive again!”

Obesity has cost Americans roughly $3.55 Billion in increased annual gas expenditures per year since 1960 because of their heftier frames.

-- CDC

“Don’t miss out on this AMAZING opportunity to change and improve your life!”

“This course really got me to realize how many inaccurate negative beliefs were driving my behaviors.  Now that I notice them I am able to make different decisions.  I feel like I have control over the trajectory of my life for the first time in my life!”

“My wife and I decided to do this course together.  It’s really amazing…after 30 years of marriage, we feel closer than we ever have!  Thank you, Dr. Pete!”

“There was no way I was going to sign up for any more weight loss programs!  I had tried them all and always had the same result…lose weight, then gain it back. This has been a totally different experience, though…I no longer even have the desire to live like I used to…I’m not going back to the ‘fat me’…ever!”

Over 30% of all Americans were obese in 2006

-- CDC

“I spent more on a brake job for my car than I did on this course…and the changes I’ve experienced in my life from this course are permanent… my brakes will have to be replaced again.”

“I lost 34 pounds in 23 days!  It’s a different type of weight loss, though…I can feel the deep fat is gone…and I did it without feeling hungry!”

Online Resources

Fields of Athenry - http://www.fieldsofathenryfarm.com
Young Living - http://www.youngliving.org/hilgartners
Open Health News - http://openhealthnews.com/

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