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February 13, 2017

I’m interested in the Radicata SEED Online Café!

Hi beautiful!

I’m so thrilled you’re interested the Radicata SEED Online Café!

Please fill out this application form and I’ll be in touch very soon so you can get started as soon as the Radicata SEED Online Café launches a bit later this Spring of 2017! 🙂

It’s completely obligation-free at all at this point. I’ll then get in touch soon for the next step.

~ The Radicata SEED Online Café
is expected to start aroud  April ~

Loves,

Aglaée

[contact-form to=’aglaee@radicatanutrition.com’ subject=’Application – Radicata SEED Protocol’][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’#1. How would you describe your relationship with food and your body? Do you binge? Are you an emotional eater? Do you feel like a food addict? Do you suffer from disordered eating or an eating disorder?’ type=’textarea’ required=’1’/][contact-field label=’#2. What would be different about your life if you didn%26#039;t think about your weight anymore?’ type=’textarea’ required=’1’/][contact-field label=’#3. List some of the most common thoughts you have about yourself, your body and your eating behaviors.’ type=’textarea’ required=’1’/][contact-field label=’#4. List 3 things you like about yourself and your body.’ type=’textarea’ required=’1’/][contact-field label=’#5. How ready, on a scale of 0 to 10, are you to heal your relationship with food and your body?’ type=’select’ required=’1′ options=’0,1,2,3,4,5,6,7,8,9,10’/][contact-field label=’#6. What areas of your life are impacted by your problem?’ type=’checkbox-multiple’ required=’1′ options=’Myself,My children,My family,My relationship with my significant other,My relationship with my friends,The relationships that I don%26#039;t dare having,My career,My physical health,My emotional %26amp; mental health’/][contact-field label=’#7. Did you take the Whole Batch Syndrome (free) Online Training with Aglaee?’ type=’checkbox-multiple’ required=’1′ options=’Yes,No’/][contact-field label=’#8. Do you have a diagnosed eating disorder? ‘ type=’checkbox-multiple’ required=’1′ options=’Yes anorexia,Yes bulimia,Yes binge eating disorder,Yes orthorexia,Yes (other),No,Unsure,Disordered eating but no eating disorder’/][contact-field label=’#9. I understand that this program is not about food and physical health (although it is part of it) and that it goes much deeper than that.’ type=’checkbox-multiple’ required=’1′ options=’Yes – that%26#039;s EXACTLY what I want!,No’/][contact-field label=’#10. I understand that this is NOT a weight loss program.’ type=’checkbox-multiple’ required=’1′ options=’Yes – that%26#039;s EXACTLY what I need!,No’/][contact-field label=’#12. Do you have anything to add?’ type=’textarea’/][contact-field label=’#13. Which of these programs are you interested in?’ type=’checkbox-multiple’ required=’1′ options=’Group classes,1:1 Coaching,Online Café,I don%26#039;t know which is best for me at this point’/][contact-field label=’#14. Why are you interested in the Radicata SEED Online Café!? (i.e. lower fee? community? want to dip your toes first? other?)’ type=’textarea’ required=’1’/][contact-field label=’#15. Would you be interested in attending live virtual café with Aglaée and other members every month?’ type=’checkbox-multiple’ required=’1′ options=’I would absolutely love to!,Depending on my schedule,I%26#039;m not sure’/][contact-field label=’#16. Which of these days %26amp; times could work for you (it would be 1-2 times a month)?’ type=’checkbox-multiple’ required=’1′ options=’Weekday during the day,Weekday during the evening,Weekend in the morning,Weekend in the afternoon,I%26#039;m flexible,My schedule varies’/][contact-field label=’#17. What time zone are you in? (if you don%26#039;t know, write your city and country please and I%26#039;ll figure it out)’ type=’text’ required=’1’/][contact-field label=’Click here if you agree to be contacted by email by Aglaée!’ type=’checkbox’ required=’1’/][/contact-form]