All participants are screened and monitored for any potential contraindications before beginning, and throughout the program. DC Program Request 2 First Name * First Last Name * Last Email * On a scale of 1-10 with 10 being unbearable, how would you rank your average day dealing with your health, energy levels, optimism that you will get better, or weight loss efforts? 1 2 3 4 5 6 7 8 9 10 On a scale of 1-10 with 10 saying you absolutely can’t function, how bad are your worst days? 1 2 3 4 5 6 7 8 9 10 On a scale of 1 to 10 with 10 saying it is ruining them, how would say your personal relationships are being impacted by your current health status? 1 2 3 4 5 6 7 8 9 10 On a scale of 1 to 10 with 10 meaning you absolutely need it to change in fear of a crisis or death, how would you rank your NEED to improve your health status? 1 2 3 4 5 6 7 8 9 10 On a scale of 1 to 10 after answering the above and upon personal review, where would you rank your readiness to take action right now to make the changes necessary to get better? 1 2 3 4 5 6 7 8 9 10 Questions, comments or concerns? Let us know! If you are human, leave this field blank. Submit