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Shape Reclaimed

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Restoring your health. Revitalizing your life.

www.shapereclaimed.com

Functional Medicine/Nutrition Intake Form

Symptom & Toxicity Questionnaire


SHAPE ReClaimed™ is a safe, effective nanomolecular dietary supplement created to decrease total body inflammation, enhance immune function, detox and cleanse–all while reducing excess weight.

SHAPE ReClaimed™ is developed out of decades of clinical experience and is the foundation of our program. What we have discovered is that the synergistic combination of ingredients in SHAPE ReClaimed™, along with our total wellness program is having astounding transformative health benefits. The result, in addition to weight loss, is a re-energized and revitalized you!

We must emphasize that SHAPE ReClaimed™ is practitioner-supervised and one part of an overall successful wellness approach and philosophy. It is not a “magic bullet” but when incorporated into the program’s protocol, along with sound lifestyle choices, the results are truly life changing.

SHAPE ReClaimed™ Benefits

-Reduce Inflammation

-Enhance Immune Function

-Detox & Cleanse

-Enhance Metabolism

-Safely Release Excess Toxic Weight

-Decrease Pain

-Improve Digestion

-Increase Energy

-Improve Sleep

-Decrease or Eliminate Rx Dependency (With Practitioner Supervision)

-Improve Blood Sugar, Blood Pressure and Blood Lipids

-Improve Mood and Mental Clarity

-Create and Maintain a Healthy Relationship with Food

SHAPE ReClaimed™ Program Includes

-Initial Consult and Evaluation for SHAPE

-Discussing Your “WHY” for Choosing SHAPE

-Customizing the Program Based on Your Health History, Progress, Symptoms and Laboratory Results

-Pre & Post Metabolic Scan

-Weekly Consultations and Laboratory Tests

-Menu planning, Helpful Food Tips and Recipes

*Disclaimer: Independent SHAPE Practitioner’s Website is not owned or operated by SHAPE ReClaimed, LLC. Any content outside SHAPE ReClaimed webpage is not acknowledgement or expressed position of SHAPE ReClaimed, LLC.*

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Our Location

Office Hours

Monday:

8:30 am-5:30 pm

Tuesday:

8:30 am-5:30 pm

Wednesday:

closed

Thursday:

8:30 am-5:30 pm

Friday:

8:30 am-1:00 pm

Saturday:

Closed

Sunday:

Closed