Intake Forms

ALL NEW CLIENTS – Please fill out numbers 1 and 3 (below).

FITNESS / BODY COMPOSITION CLIENTS – Please also fill in no.2 (below)

HEALTH / FUNCTIONAL MEDICINE CLIENTS – You also should have received an email with a link to a comprehensive questionnaire, which we will need you to fill out prior to your initial appointment. If you haven’t received this email, please check your junk mail. If you still haven’t received it, please email info@jackgalloway.co.uk

Failure to complete your form 48 hours prior to your appointment may result in inability to conduct your appointment on the day, and cancellation charges will apply. So PLEASE fill out the form with ample time.

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If you have had your GENETICS screened for via 23andme and want help with interpretation:

Please login to your page on the 23andme website, download your raw data, and generate a variant report here – https://mthfrsupport.com/sterlings-app/

Please then forward your report to info@jackgalloway.co.uk

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1) Basic Info, Terms and Conditions

2) PAR-Q Form

3) 3 Day Food Diary (Word Doc. Please download, fill in and email back to me)