Health and Wellness Client Profile

Welcome to our Health and Wellness Practice. Thank you for your interest.

As a Health and Wellness Coach, I strive to form partnerships with clients enabling collaboration and resulting in the identification of opportunities for enhancement to well-being as the product of self-directed change. Transformation to your health status can be long-lasting if it is aligned with your unique strengths and values. You are the expert concerning your health and well-being. I seek to empower that expert.

Michael J Brandt, MS CHC

INFORMATION REQUESTED HERE

The short questionnaire following this page asks for your contact information and includes a few questions that will assist our office to reach out to you in the most efficient manner. Please attempt to answer each question, but do not feel obligated to answer any question you feel may not apply.

Any information forwarded by yourself here is considered private and confidential and is treated as such in accordance with applicable Federal and State regulations, the U.S. Department of Health and Human Services (HHS), and HIPAA Privacy and Confidentiality Security Rule Requirements.

Forwarding of information here results in no obligation whatsoever on your part ... the Client Profile following serves only to signify your interest in the Health and Wellness Practice services of Michael J Brandt and mjbrandt.com.

You may cancel or discontinue your participation in the questionnaire at any time ... your information will not be saved.