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Apply for a free introductory coaching session!
Hello, bariatric friends! 

Are you serious about transforming your health and well-being through sustainable habits change? As a bariatric health coach, I'm here to help you develop and stick with habits that have previously been a struggle.

First, please read the Bariatric Coaching FAQs. Then fill out this form to apply for a free, 30-minute introductory bariatric coaching session.

If you are selected for a free introductory session, I will reach out by email to arrange a Zoom meeting time. No purchase or program sign-up is necessary for this free session.

Availability is limited, so please provide as much detail as possible in your answers! 

Shaina
Gastric Sleeve Glow Up

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Email *
What is your name (first and last)? *
What is your date of birth? *
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What is your gender? *
Have you read the Bariatric Coaching page? *
Where are you on your bariatric surgery journey? *
When was/is your surgery date? Or when do you hope to have surgery? *
What kind of surgery did you have/do you plan to have? *
What are your reasons for having bariatric surgery? *
How do you hope bariatric coaching will help you? *
What habits are you working on that you could use help with? *
What kinds of struggles, fears, or concerns are you currently experiencing on your bariatric journey? *
How interested are you in signing up for my 12 week Empowered Habits one-on-one coaching program? *
What questions do you have about bariatric health coaching? *
Which of the following times would you typically be available for a coaching session? All times listed are Mountain Time Zone. *
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What is your time zone? *
Bariatric coaching is not a medical service. Shaina Robbins (Gastric Sleeve Glow Up) is not a doctor, dietitian, therapist, or healthcare professional and her comments are not intended as medical advice. I do not and will not hold her liable for my physical and mental health choices.

Health coaching instead is intended to help me incorporate habits of my own choosing into my life in accordance with the guidance of my medical team.
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