Nourishment Coaching Application
Full Name
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Best Email
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Phone #
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Do you prefer phone call or video chat?
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I have concerns with... (check all that apply)
Do you already have a basic understanding of nutrition and/or macronutrients (protein, fats, carbs?)
Do you label certain foods as "good" and "bad"
Do you feel guilt or shame around eating certain foods?
Do you have any food sensitivities and/or allergies? If so, please explain and let me know how you discovered them.
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What your biggest "challenge area" for you that you would like support in?
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What have you tried in the past that worked?
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What have you tried in the past that did not work?
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Do you currently have any stress reduction and/or self care practices? (ie meditation, yoga, time in nature, walking, creative expression etc) if so, please explain what they are and how often you practice them.
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What would you like to walk away with from our work together?
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On a scale of 1-10, how committed are you to showing up and working together with me?
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Is there anything else you would like me to know?
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