Kim Waggoner Health Discovery Call

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Spaces are limited for my 1:1 health coaching programs so that I can give my FULL ATTENTION to my clients.

My 1:1 Health Coaching Programs will give you the tools, strategies and CONFIDENCE you need to set you up for long term success and support you for life. I take a holistic approach to health-mind, body and spirit.

This application will give me a good idea of your current health struggles/goals, and to ensure we are a good fit moving forward.

To learn more about working with me, watch the Program video below.

After I receive this application, I will review and reach out to you within 24 biz hours.

Here's to your health!

Kim

Watch Program Video HERE! Then complete the application! (note you can change the replay speed to watch faster!)

First and Last Name *

Email *

Cell number *

What is the best way to contact you to discuss your next steps? Email? Instagram or Facebook messaging? Text? Please provide that contact information. *

What are your current struggles? Check all that apply. *

Low energy

Want to lose weight

Digestion issues (heartburn, constipation, bloating)

Skin issues (acne, rashes, etc)

Post menopausal issues-Hot flashes, night sweats, painful intercourse

Mental Fog

Anxiety or Depression

Not eating healthy foods (fruits, veggies, whole foods)

I don't exercise

Pain (body, joint etc)

Other:

Required

If you wish to lose weight, how much weight do you need/want to lose?

Have you ever used an app to track your food? *

Yes

Are you open to using a tracker for a short period of time during your coaching experience? *

Yes

Maybe

Do you do well with high accountability? *

Yes

Other:

Are you looking for an overly structured/strict meal plan, or does something a bit more flexible sound appealing to you?
*

What is your number one health goal? *

What do YOU think has been holding you back from reaching that goal? *

What have you tried before to help improve your health? *

WHY do you want to improve your health *

On a scale of 1 to 10 how committed are you to investing time, resources and effort into making healthy lifestyle changes? *

Not really

I am commited and ready to take action now

This program is an investment in YOU :)

It takes approximately 4-5 months to complete.

You will get an abundance of transformational tools and resources. You will learn healthy habits that are sustainable and will carry you throughout your lifetime.

I have 2 levels of support from 1:1 coaching to more self-led. There is an option for every budget! One on one coaching is my gold standard transformational program and about 80% of my clients choose this level of support!

I do offer flexible payment plans. Some of my clients are able to use their HSA/Flex spending as well.

If we decide we are a good fit for each other are you willing to make a financial investment in yourself as well? If yes what are you willing to do at this time?

$200-350

$350-$500 per month

I would like to pay in full for a 10% discount

I would need an additional payment plan option

Do you have any reservations about joining a coaching program? If so list them here. *

Is there anyone else that is involved in your decision-making process (a spouse)? If yes, have you spoken with them about hiring a coach to help you reach your health goals? *

I am the only decision maker

Yes but I have not spoken to them

Yes and they are aware and supportive of me moving forward

Other:

If we are a good fit and decide to work together during our phone chat, how soon would you like to get started? *

ASAP

2-4 weeks

4-8 weeks

What is one life accomplishment you are most proud of? *

Is there anything else you want to share with me? *

Submit

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