Complimentary Counseling Session with Gabriele Kushi

I invite you to a complimentary and free counseling session with me.

In this free session you will be talking with me directly and I will be able to advise you what your best next step is to reach your food and lifestyle goals. I am looking forward talking to you soon.

If you feel comfortable or if you already talked with me, please be sure to down load and fill out the forms below. This will make it a lot easier for all of us. The forms should be returned to me (Gabriele) via the Submission Form at the bottom of the page. Privacy Policy: Your Intake form is private and we do not share any information with other parties, unless ordered by law.

If you don't feel comfortable to fill out the Intake Forms yet, please just send me your Name and E-mail and we can start to talk without them.

Women's Intake Form

Men's Intake Form

Client Bill of Rights
(To sign the Client Bill of Rights, simply type in your Name and Information at the end of the form)

Be sure to attach your forms!

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