Shani Mara | Registered Dietician and Nutritionist for Kids and Teens | Survey

Free Call Questionnaire

15 minute Free Call “Next Step” Questionnaire

Shani Verchick, RDN
The Leading Registered Dietitian for Kids and Teens

First Name*
Last Name*
Phone*
Address
City State / Province / Region ZIP / Postal Code Country
Email*
Can you Skype?
- Yes
- No
Can you Facetime?
- Yes
- No
What has inspired you to connect with me?*
How long has it been this way?
What will achieving this goal do for you personally?
Tell me about each member of your family, their age and how I can help.
What date and time did you sign up for your free call?