Intake Form

Please fill out the following confidential form and Emily will be in contact as soon as possible. Thank you.

For urgent or timely requests (interviews/media appearances) please contact Emily directly at 587.987.5595 or emily@choosefoodfirst.com

    Request Form

    I have read about services offered by Food First Nutrition Consulting and I would like to:

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    Your Personal Information

    First Name:
    Last Name:
    Date of Birth (mm/dd/yyyy):

    Your Contact Information

    Street Address:
    Unit:
    City:
    Province:
    Postal Code:
    Home Phone:
    Cell Phone:
    Email Address:
    Preferred method of communication:

    Your Appointment Information

    My nutrition goals include:

    eating for sport performancegaining lean musclemanaging food allergy or intolerancesupporting nutrition for my infant, child or teeneating for a healthy pregnancyother, write below:

    Additional information you wish to share:

    Don't live in Edmonton, or prefer online coaching? Emily also offers appointments by telephone and video conference.

    Yes! I am interested in working with Emily by phone.Yes! I am interested in working with Emily by video conference.

    How did you find out about Emily?

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    Note: All information is protected and confidential.

    Intake

    Intake Form

    Interested in booking an appointment? Start the process here!

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    Player Login

    FC Edmonton players login here to view nutrition plans and resources.

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    Question

    Consent Form

    Before nutrition services can begin, all clients are asked to review, and if agreeable, sign the client-provider agreement.

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