Let's work together.

Please fill out this application thoroughly so I can better understand how we can work together. I’ll follow up via email within 24-48 hours with next steps.

First Name

Last Name

Phone *

Email *

How did you hear about Amy Liu Wellness?

What are you currently struggling with?

Chronic joint pain

Autoimmune condition(s)

Hormone imbalance

Weight loss resistance

Menopause/Perimenopause

Low energy levels, brain fog

Gastrointestinal symptoms (IBS, IBD, reflux, nausea, vomiting, diarrhea, constipation, food sensitivities)

Other symptoms/concerns not listed:

What prompted you to reach out?

Tell me about your health goals -- what are you hoping to achieve in the next 6-12 months?

What has been your biggest barrier in achieving these goals?

My program uses a functional medicine approach designed to support deep healing and transformation in just months. Achieving these kinds of results involves both a mental and financial investment. How prepared do you feel to commit on both levels?

Let's work together.

Please fill out this application thoroughly so I can better understand how we can work together. I’ll follow up via email within 24-48 hours with next steps.

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