Health Mentoring Collaboration Call Form


In order for Jenny to make the most of our Health Mentoring Collaboration Call time talking together, it would be very useful if you could answer these questions.

Any information provided will be treated confidentially. 

Please submit the completed form prior to our scheduled call time.

Many thanks


Why are you seeking health support at this time?


At this moment in time, how would you describe your level of well being, energy and self-care?

Have you been offered a conventional diagnosis and what symptoms are you experiencing?

Are you taking any prescribed or over the counter medications?

What abilities, passions and dreams are being curtailed by your challenges?

What are the three most challenging aspects of your life at present?

What kind of moments brings you joy and fulfillment?

Is there anything else you would like to share?

Which phone number or skype ID is most appropriate to use for our session, unless this session is in person?