Getting To Know You!

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I am more than excited to begin our journey together. Who are you? What defines you? Take a few minutes and fill in all of the little things I will be privileged to know about you. Let's get started!

Name *

First, Last

E-mail Address *

Phone Number (Only to be known by me!) *

What words best describe yourself?

Adventurous

Cautious

Passionate

Caring

Charismatic

Organized

Loyal

Faith-based

Other:

How would you describe your health and wellness journey so far?

I have been in shape for 10+ years and have always been healthy.

I have been exercising regularly for 5-10 years and also eat healthily.

I have been exercising regularly for 5-10 years but find it difficult to maintain proper nutrition.

I have been exercising regularly for the past 3-5 years and eat very healthily.

I have been exercising regularly for the past 3-5 years but find it difficult to maintain healthy eating habits.

I have been exercising for 1-3 years and eat healthily.

I have been exercising for 1-3 years and struggle with healthy eating.

I am brand new to healthy eating and exercise!

I am relatively new to exercise but have been eating healthily for awhile.

Clear selection

Which best describes you currently?

Check all that apply!

Employed Full-Time

Employed Part-Time

Unemployed

Stay-At-Home Mom or Dad

Small Business Owner

Ready for a BIG change in my life

Other:

Please consider the following statements and put your responses below:

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I am a very organized person who likes to set timely goals for myself.

I am self-motivated and am prepared to develop my own business from home.

Clear selection

What fears do you currently have about becoming a Coach, continuing your fitness journey, and helping others?

How much time, daily, do you estimate that you have to invest in beginning your own business as a coach?

30 minutes

1 hour

1-2 hours

2-3 hours

3+ hours

Clear selection

Making goals are SO important in your life and as a Coach. What are the 3 goals you have right now for yourself?

Will your spouse/significant other support you in this fitness and business journey?

Yes

Maybe

I do not have a significant other/spouse at the present time

Clear selection

I have asked you a lot of questions at this point. What questions do you have for me?!

We will schedule a follow-up call to this form once I've received it. What day(s) of the week are you available for this call? *

Monday AM

Monday PM

Tuesday AM

Tuesday PM

Wednesday AM

Wednesday PM

Thursday AM

Thursday PM

Friday AM

Friday PM

Saturday AM

Saturday PM

Sunday AM

Sunday PM

Required

Last Question, I promise! If you could change 3 things in your life at this exact moment, what would they be?

Submit

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