Cancellation Form

Name

First Name

Last Name

1. Please select an option that best describes your reason for cancelling your Focused Nutrition plan?

2. How well did Focused Nutrition staff attend to your nutrition goals?

3. How would you describe your overall satisfaction with Focused Nutrition?

4. How likely are you to recommend a friend or family member to Focused Nutrition?

5. Did you achieve the goals you desired when starting with Focused Nutrition?

6. Please give us some feedback on your experience with Focused Nutrition and how we could improve the service.

7. As per the terms and conditions of this membership, I understand that my non-refundable membership renewal payment will be processed if this request is submitted less that 30-days before my renewal date.

Please tick to confirm

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