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The Whole You Program Application
This form is to help me get to know you better! Please answer as honestly as possible so that we can make the most out of working together. I am excited to watch you journey unfold.
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What is your first & last name?
Your answer
What are you struggling with currently? (Weight, lack of exercise, poor nutrition, self-sabotage, feeling stuck, etc.)
Your answer
How do you view your life?
Optimistic
Stressful
Overwhelming
A rollercoaster
Balanced
Other:
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How would you like to view your life?
Your answer
What is the #1 obstacle that has been holding you back?
Your answer
What are you most grateful for in your life?
Your answer
What are your daily practices currently (Ex. journal, movement, meditation, alone time etc) It's okay if you do not have a daily practice yet.
Your answer
What are your biggest goals to improve your life?
Your answer
Have you ever worked with a coach before?
Your answer
Are you willing to invest time and resources into your growth and development?
Your answer
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