Join Tanya's waiting list

**Please note, I have reached capacity for new 1:1 clients until the summer 2023 intake. You can of course still submit a request to join the waiting list by completing this form**

To get started, I ask you to fill out this form and tell me about your health concerns. This is to ensure that you are a good medical fit and that your health goals are the right match for my practice.

Once completed and I have reviewed it, my Clinic Manager will be in touch with you within 48 hours with further information to arrange your phone call.

Please complete all fields of the form below. By submitting this form you are agreeing to our Privacy Policy.

Contact Details

Full name:	*
Email address:	*
Telephone Number:	*
Date of Birth (DD/MM/YYYY):	*
Height (cm):	*
Weight (kg):	*
What are your goals?	*
Please give a brief description of the health complaint you are seeking help with?	*
Allow Contact:	Yes please - I would like to receive communication via email & telephone, and have read the terms and conditions *
	*
	Please add the two numbers

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