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:

Find out moreBook an appointment

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?

TwitterFacebookLinkedInTelevisionFamily or Friend

Confirmation

To help distinguish between comments submitted by individuals and those automatically entered by software robots, please type the letters shown in the image.

captcha

Note: All information is protected and confidential.

Intake

Intake Form

Interested in booking an appointment? Start the process here!

Read More

Player Login

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

Read More
Question

Consent Form

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

Read More