Concierge Health Guidance | The Femme Ignited

First name

Last name

Email

Current Profession / Career Background

City & State

What prompted you to reach out at this time?

Which areas are you primarily seeking guidance or clarity around right now? (Select all that apply)

Health foundations (sleep, stress, recovery)

Longevity and sustainable wellness

Understanding lab work or health data

Hormonal transition (perimenopause / menopause)

Burnout prevention and nervous system support

Career transition or reinvention

Advocacy and navigation within the healthcare system

Other (please describe)

If you selected "Other", please briefly describe)

How would you describe your current pace?

Overwhelmed and looking for quick relief

Managing, but concerned about long-term sustainability

Stable and seeking education and clarity

In transition and needing grounded support

What are you hoping this guidance will help you understand, navigate, or reframe?

Which statement best reflects your understanding of this service?

Educational and guidance based support

A replacement for medical care

I am not entirely sure and would appreciate clarification

Are you currently under the care of a healthcare provider?

Yes

No

Prefer not to say

This guidance is intentionally paced, reflective, and non-urgent. How does that feel to you?

Please add any additional information you feel would be important for me to know at this stage

This section helps me understand the topics you are currently curious about or exploring. Selecting an option does not imply services are provided or recommendations will be made.

Is there anything specific within these areas you're currently curious about or navigating?

Acknowledgement Required

I understand this is a nurse-led educational guidance, not medical care.

I understand this does not include diagnosis, prescribing, or treatment

I understand availability is limited and not guaranteed.

concierge health guidance form