Cancer Coaching Assessment Form

The Natural, Alternative "Metabolic Cancer Healing Lifestyle" Coaching Program

Assessment Form

Please only submit this form if you are interested in finding out more or developing a "natural alternative "metabolic cancer healing lifestyle" program"

There is no problem if you are currently having the  "standard cancer treatment" (surgery, chemotherapy and/or radiation) or whether you had it previously, but please include this information in the assessment form as that is very important and critical to the success of your alternative healing Program. Both Chemo and radiation destroy your immune system and make it very difficult for your body to fight the cancer naturally.

This form has been designed to enable me to assess whether I believe a natural, alternative cancer healing program will benefit you or not.

For this reason it is very important that you answer the questions truthfully for your own benefit. Your information is strictly confidential and will NEVER be shared with 3rd parties but it is important that I know your true situation to be able to best serve you.

Unfortunately there are certain conditions where an alternative healing program may not be suitable and I don't want to accept payment from anyone if I believe the program wont benefit you !

Free Telephone Appointment

Once you have completed the Assessment form and submitted it, you will get a confirmation e-mail, so your  Skype handle and your e-mail address on the form are  very important.   I will assess your form in 24 hours and e-mail you the results and if positive I will set up a FREE Skype session to discuss your personal details and explain exactly how the coaching program works and what the main goals of the Program are.

Final Decision

You will only have to make a final decision to join the program after your FREE Skype session, at which time you will be given a link to the payment page which will trigger the start of the Coaching Program as described in the Introduction to the Program.  Up to this point everything is FREE !!!

Program Payment

As your Cancer Healing Lifestyle Program is the most critical requirement to successfully beating cancer, my unique "Cancer Healing Lifestyle" Coaching Program has been created to guide and assist you to develop a customized Cancer Healing Lifestyle Plan and Schedule that will be your roadmap on your cancer healing journey. The Program  is designed to provide you with detailed information with both e-mail and weekly "one-on-one" Skype sessions (9hrs) over a 3 month period and then on a monthly basis thereafter if you so wish. 

The cost of the 3 month "Metabolic Cancer Healing Lifestyle" Coaching Program is $3,600 with a 20% discount($2,880.00) if paid in full up front. There is also a monthly option of 3 monthly payments of $960.00 in advance, monthly.

After the initial 3 months you can sign up for a monthly service of $650.00 which will include e-mail support and a bi-weekly Skype session. *45 minutes).  

Please fill in the Form Below. Please NOTE that the small circle that you have to select in the form is in front of the topic although it might be at the end of a line in some cases, in that case it applies to the point in the next line.

Thank You for your interest in my Unique "Metabolic Cancer Healing lifestyle " Coaching Program. I  look forward to hearing from you -




(Stage 4 Metastasized Cancer Conqueror) 

Personal Information