Starter Action Plan

Home
- About Us >
Free Resources
Support Services
- TLC Consultations
TLC Coaches

Starter Action Plan

Your journey to optimal health starts by completing our Starter Questionnaire. Simply complete and submit this short form, and OptiHealth will send you a free personal "Starter Action Plan" by email based on your responses.

* Indicates required field

Name: *

First

Last

Email: *

Phone #: *

Optional: For text messages only.

City: *

State: *

Or Country, if outside the U.S.

Postal Code: *

Age: *

Gender: *

Male Female

Height: *

Weight: *

Lifestyle-related issues (mark all that apply): *

I eat a typical American diet. I don't get enough exercise. My coping skills could be improved.. My stress level is elevated. My blood pressure is elevated. My cholesterol is elevated. My blood sugar is elevated. I'm taking Rx/OTC medication daily. I'm sick & tired of being sick & tired.

Level of Readiness for Lifestyle Change: *

Referring Health Professional (If known): *

If unknown, leave blank.

Question or Comment (Optional): *

Submit

Privacy Policy

Watch for an email from DrOpsahl @ OptiHealth Network. Check your spam if you don't see a response in your inbox within the next 2-3 days.

Return to Resources

OptiHealth Network
Creating a Culture of Optimal Health

Powered by Weebly