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Digestive Strategy Session Application

Please answer the following questions to see if you qualify for a FREE 30-Minute Digestive Strategy Session with Dr. D. LeGrand Peterson, ND!

***It will take you less than 5 minutes to answer the questions***

Click the button below to start.

Start

Question 1 of 16

Do you have abdominal pain?

A

Yes

B

No

Question 2 of 16

Do you have gas and bloating?

A

Yes

B

No

Question 3 of 16

Do you have constipation or diarrhea?

A

Constipation

B

Diarrhea

C

Both

D

Neither

Question 4 of 16

Are you stressed?

A

Yes

B

No

Question 5 of 16

Do you take any supplements for your digestion?

A

Yes

B

No

Question 6 of 16

Do you have heart burn?

A

Yes

B

No

Question 7 of 16

Are you taking any medications for your digestive issue?

A

Yes

B

No

Question 8 of 16

Do you have trouble with sleep?

A

Yes

B

No

Question 9 of 16

Do you have other health concerns?

A

Yes

B

No

Question 10 of 16

Do you feel fulfilled in life?

A

Yes

B

No

Question 11 of 16

How soon do you want to begin your wellness journey?

A

Now

B

1-2 months

C

3-6 months

D

> 6 months

Question 12 of 16

How long do you think it will take to achieve the level of health and happiness you desire?

A

< 1 month

B

1-2 months

C

3-6 months

D

6-12 months

E

1-2 years

F

> 2 years

G

Never

Question 13 of 16

What is your present level of commitment to address any underlying causes of your signs and symptoms that relate to your lifestyle? Rate from 1-10 (10 being 100% committed)*

A

10

B

9

C

8

D

7 or less

Question 14 of 16

Are you willing and able to do virtual telemedicine video consults?

A

Yes

B

No

Question 15 of 16

How much are you willing and able to invest in yourself PER MONTH to be able to thrive in your health, wellbeing, and life? (That will NOT be covered by insurance at all).*

A

less than $100/Month

B

$100-250/month

C

$300-400/month

D

$400-700/month

E

$700-1000/month

F

$1000-2000/month

G

I'm willing to invest as much as it takes to feel better

Question 16 of 16

Are you willing to commit to a 6-month program in order to see the results you want?

A

Yes

B

No

C

Tell me more first

Confirm and Submit