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Request a Personalized Wellness Plan
Tell us a little about yourself so we can design a wellness plan tailored to your goals, dietary needs, and emotional well-being. Your journey toward balance and healing begins here.
Full Name:
*
Phone
Email
*
Preferred Contact Method:
Phone
How comfortable are you in the kitchen?
How often do you currently cook at home?
What are your current wellness goals? (Select all that apply)
Stress management
Grief or emotional healing
Healthier eating habits
Weight management
Increasing energy
Building community / connection
Other
What area of your emotional or mental health would you like to improve through this program?
What do you hope to gain from your personalized wellness plan?
Are you currently working with a therapist, counselor, or wellness coach?
Choose one
How soon would you like to get started?
As Soon As Possible
Preferred Format:
Choose one
Anything else you’d like us to know before we connect?
I’d like to receive emails with resources and upcoming events from In His Image Culinary Wellness.
Submit My Wellness Interest Form
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