A healthier, more balanced life.Please fill out the form below and we will be in touch shortly! Name * First Name Last Name Gender * Male Female Date of Birth * Email * Phone Country (###) ### #### Type of Appointment * Initial Dietetic Consultation [60 minutes - £30] Follow up sessions after initial consultation x2 [30 minutes each] Additional follow up session (after consultation and follow up sessions) Online or In-Person? * Online In-Person What best describes your nutritional goal? * Weight Gain Weight Loss Gut Health Diabetes (Type 2) High cholesterol/Hypertension (high blood pressure) Mood/Energy Other If other, please let us know below Any additional information you would like us to be aware of before your session? E.g. Medical history Date Please select your preferred date and time. Note: We will try our best to meet your preferred date and time. MM DD YYYY Time Hour Minute Second AM PM Thank you for reaching out to Eclectic House.A member of our team will be in touch shortly.
