Making Appointments

EthiCal provides nutrition and exercise counselling in the convenience of your own home.

You have two options:

  1. Call EthiCal on 0409695949 to make an appointment - a consultation charge of $85 will apply

OR

  1. Receive a $20 discount by completing the requested information below, and clicking on the REGISTER button below.

To be eligible for a $20 discount on the first consultation, complete the form below and click on the REGISTER button at the bottom of the page.  Your answers to the questions will be sent to me as an email and will provide me with background information about you, about your eating and exercise habits, and about your readiness to make a lifestyle change.  Answer as many questions as possible so that I can get a good snapshot of you and your current lifestyle habits.

My name is:
 I am:
 My age is:
years
. (if you are under 18 it is inappropriate for you to be trying to lose weight)
. . .
My address in Alice Springs is:
 My phone number is:
 My mobile number is:
If you do not live in Alice Springs we may be able to put you in contact with an Accredited Practising Dietitian anyway. .
. . .
My height is:
 My weight is:
 I will be paying by:
. . .
My Lifestyle Habits
MORNING AFTERNOON EVENING
I normally eat the following for breakfast:
 I normally eat the following for my midday meal:
 The following meals are the range of meals I eat for my evening meal:
enter as much information into the boxes as you can, the more information the better    
. . .
I normally eat the following for a mid morning snack:
 I normally eat the following for an afternoon snack/before the evening meal:
 These are the kinds of foods I eat after the evening meal:
. . .
My favourite evening meals are:
 My favourite snack foods are:
 My favourite alcoholic/ non-alcoholic drink is:
.    
My favourite way to exercise is:
 I do my favourite exercise:
. (replace dots with your exercise duration and frequency) .
     
The Cycle of Change:
In terms of making a committment to making changes to my eating and exercise habits, I would say that I am at the following stage (choose one response):  
Preparing to change
> .,-. > .,-. > .-,. >
Making Changes
> >
> >
> >
. > >
Thinking about change The Cycle
of Change		 Maintaining Changes (Leading a Stable, Healthier Lifestyle)
^ < <
^ < <
^ < <
^ < <
My Doctor recommends change Not interested in change
< .,-. < .,-. < .,-. <
Relapsing
..

.

 .
Additional Comments
.  
.  
.

To register for EthiCal Weight Consulting, ensure that you are connected to the Internet, and 
then click on this button now.

In most cases your email software to open, a message with all your responses will be composed, and all you need to do is click SEND

Alternatively you can print out this page (with the details filled in), and post to

Roy Price, Dietitian
EthiCal Weight Management
PO Box 1326
Alice Springs NT 0871

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