IHC of Charlottesville - Free Additional Month Limited Time Offer

Don't just lose weight,
transform your health

We can help you lose 30 to 100+ lbs and transform your life without fad diets or extreme workouts!

Pre-Scheduling Questionnaire

We’re so excited you’re considering joining our program! At IHC we are committed to our clients success and we’d love to learn more about your goals and needs. Please take 2 minutes to answer the following questions honestly. There are no wrong answers—this is all about YOU!

First Name

Last Name

Phone *

Email *

What inspired you to take the first step toward your weight loss journey today? *

On a scale of 1 to 10, how serious are you about making changes to reach your health and weight loss goals right now? *

Have you tried other weight loss methods before? If yes, which ones? If they didn't work, what do you think was missing or didn’t work for you? *

What is your primary goal with this program? *

Are you comfortable making decisions about your health and finances independently? *

Our program is an investment in your health. Are you in a financial position to invest in yourself right now? *

What level of weight loss are you looking to achieve? *

How would you describe your current health and activity level? *

How far are you willing to travel for in-person appointments, if required? *

Is there anything that might prevent you from fully committing to your weight loss journey right now? *

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