First Name *

Last Name *

Email *

What is the best mobile number to reach you on? *

Instagram handle? *

What are your current Health + Fitness goals? *

What have you tried in the past to reach your goal? *

HOW do you want to look and feel in the next 8-12 months? (fill in the blank) (Sexy, Confident, Energetic, etc?) *

How ready might you be to get started? On a scale from 1-10, if 1 meant 'not ready', and 10 meant 'absolutely ready', what number would you give yourself? *

How willing are you to invest financially in long-term health & fitness goals? *

YES! I am willing to make the investment to reach my goals with both accountability and structure from a coach. This is a serious, long-term change for me to reclaim my health and happiness.

I am unsure if I can financially invest but am happy to work with you on program / payment options so I can make a decision by the end of our call

I am not financially stable to invest in myself or in my goals / it's not a huge priority right now.

If you do feel like we can help you get to your goal, would you be able to work with us on different financial options so we can make this vision come to life for you? *

Sure! That would be helpful

I don't think so :(

What are 2-3 things you spend money on each month that are moving you further AWAY from your goals? (ex. Fast food, nicotine, alcohol, etc.) *

If you had to guess, how much is that costing you on a monthly basis? *

Would this be a joint decision between you and your partner? If so, we'd love it if they could hop on the call as well! *

Yes, they play a role in this decision

No, this is 100% my decision

Be sure to be in a place where you're fully present and good internet/wifi. And NO driving please!! Sound fair enough? *

Yes, of course.

I can't guarantee anything

Do we have consent to record our call for quality purposes? *

Yes

Where did you receive this application form? *

Coach sent it to me

Website

Social Media

Referral