Plant Focused Kidneys Coaching Application
Apply to work in my coaching program!
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Ready to preserve and protect your kidney function? Watch my 5 minute video! 
Full Name *
Email Address *
Phone Number *
Social Media Handle or Name
Are you at least 18 years old and located in the United States?
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How did you find out about Plant Focused Kidneys?
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What prompted you to reach out to me for help? *
What are your biggest challenges or roadblocks with improving your kidney function? *
What stage of CKD are you right now? *
On a scale of 1 to 5, how committed are you to making changes with your nutrition? *
Are you looking for an overly structured/strict meal plan or does learning the basics on how to eat for your kidneys sound appealing to you?
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At this time, investment into this program depends on the level of support you need, but begins at $297/month x 3 months for group coaching and $597/month x 4 months for private coaching. I offer a 10% discount if paid in full. I understand everyone's budget is different when it comes to investing in your health, so I am happy to offer flexible payment options (ex. 5 monthly payments instead of 4) and also accept HSA & FSA so that this program can work for you! Are you willing to make a premium investment in your nutrition goals and a coaching program?  *
If you live in South Carolina and have Original Medicare (NOT Medicare Advantage Plans), I can bill your insurance for reimbursement of single session services. *Please note that multiple sessions are encouraged as my most successful clients work with me for a duration of time for support and accountability* 
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Do you have any reservations about joining a nutrition coaching program? If so, please list them here! *
Is there anyone else involved in the decision-making process that needs to be involved on our call? *
If we decide we are a good fit to work together during our phone chat, will you be ready to start in the next 30-60 days? *
How do you prefer I contact you to review this application?
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