Sports Nutrition Consultation Request Form

One-on-one consultations at the HERC

EIU athletes have the opportunity to meet with the Sports Nutrition Coordinator for FREE one-on-one nutrition consultations. Consultations serve as an opportunity to receive nutrition education and advice that is tailored to one’s individual needs.

This form will be sent to the Sports Nutrition Coordinator once completed. You will be contacted shortly after to schedule a date and time for the consultation. If you have any questions or concerns you may contact the Sports Nutrition Coordinator at sportsnutrition@edu.edu.

Please note: to make an appointment with a Liscensed Clinical Counselor you must contact the Counseling Clinic at 217-581-3413.

Name Name * First Last
Phone Phone - ### - ### ####
Panther Email *
What is the best way to contact you? *

What is the best way to contact you? Phone Email
Please identify a possible date you would like to meet. We will do the best to accommodate, if we are not available during this day we will work with you to schedule a day and time. Please identify a possible date you would like to meet. We will do the best to accommodate, if we are not available during this day we will work with you to schedule a day and time. / MM / DD YYYY
Please identify a possible time of day:
Please provide a brief explanation of your reason for meeting in order for us to prepare for your consultation.