YOUR CLIENT INTAKE FORM

Welcome to the Radiant Roots Renewal Method

Thank you for saying yes to yourself. Before our first session, I'd love to look at the whole picture with you. This intake helps me understand what's been going on underneath your symptoms — so when we sit down together, we can go straight to the root.

BEFORE YOU BEGIN

A few things to know

Take your time. There are no right or wrong answers here — only your truth. The more honestly you can share what your body has been carrying, the more clearly we can see what's really going on underneath. One thing at a time. Let's look at the whole picture together.

"What is your body trying to tell you?" — This form is the first place we start listening.

HERE'S WHAT HAPPENS NEXT

Your path into the work

A gentle, grounded onboarding — built to meet your nervous system where it is.

Complete Your Intake

Share your history, symptoms, and goals in the form below.

48–72 Hour Review

I personally review everything you share and prepare for our work.

A Week of Inner Voice Scans

Daily AO Scans capture what your body is expressing at a cellular level.

Your 90-Minute Onboarding

We sit down together, built on your data, and map your path forward.

YOUR INTAKE FORM

Let's look at the whole picture

Please complete each section as fully as you're able. Anything you share stays confidential between us.

Questions before you submit? Reach out to ellena@radiantrootsfunctionalwellness.com

A NOTE FROM ELLENA

I know this can feel like a lot.

If you've spent years being told it's "just aging" or "just stress," answering these questions might stir something up. That's okay. You don't have to have it all figured out before you start — that's what we're here to do together.

I lived 25 years of unresolved symptoms before I understood what my nervous system was trying to tell me. So when you fill this out, know that it's being read by someone who's actually walked this path — not just studied it.

We have to look at the root. And we start here.

— Ellena

A FEW QUICK ANSWERS

Before you fill out the form

How long does the intake take?

Most clients spend 20–40 minutes on it. Take breaks if you need to — your progress won't be lost. The depth you bring to this form directly shapes how targeted our first session can be.

What happens after I submit?

Within 48–72 hours, I'll personally review everything you shared. You'll then receive instructions for your week of daily Inner Voice scans and the link to book your 90-minute onboarding session, built entirely around your data.

Is what I share private?

Yes — completely. Your intake is confidential and only read by me. Nothing you share is used anywhere outside of our work together.

What if I don't know the answer to something?

That's okay. Leave it blank or write "not sure." Sometimes the not-knowing is its own useful information — we'll uncover it together.

What tools will we be using?

Your program uses AO Scan (Inner Voice, Enhanced Vitals, Body Systems) and HTMA hair mineral analysis as core diagnostic tools — so we can see what's actually driving your symptoms at a cellular level, not just what shows up on the surface.

YOU'RE ALREADY DOING THE WORK

Filling this out is the first step home.

It doesn't have to be complicated. One question at a time, one breath at a time. I'll meet you on the other side of the form.

Go to the Intake Form

Need help? Email ellena@radiantrootsfunctionalwellness.com