If you're interested in being considered for our BACK TO YOU accountability group, thats starting next month, please fill out the form below! I will get back to you ASAP! (Within 24 hours on the weekdays, 72 hours over the weekends).

I know sharing some of the info on this form can make you feel a little vulnerable, but I can promise you, that you won't regret getting started on your health and wellness journey with me as your coach!

After going through my own fitness journey over the past several years, I can WITHOUT A DOUBT say that having a coach like me and an accountability group is the best thing you can possibly do for yourself! Why do it alone when you can have the SUPPORT of others along side you?! I know what it takes and I am still on this journey WITH you, every step of the way!

My coaching is 100% complimentary! Your only investment is the complete home workout program and nutrition package that is best for you. My goal is helping you achieve sustainable results and making lifestyle changes, so it's important that I get to know your needs, goals and struggles, which is what this form will help me do! So please take it seriously as this is the only way I will be able to provide recommendations and to help you determine if this group is the right fit for you!

Once you submit the form, I'll get back to you in the next 24-72 hours, letting you know if you have been selected. I truly wish I could work with everyone, but I have to make sure I limit the amount of new clients I take on each month. I need to make sure I can provide the best support possible to those that join. I hope you understand!

Again, please take this form seriously and don't rush through it! I won't be picking participants based on speed, I will be picking based on the info you provide! I want to work with those who are ready for change and I need to know your needs, goals and struggles, to decide if what I offer is the best fit for you. I can't wait to chat with you more! Let's get started together!

*This group is NOT for those already happily working with another coach or currently a coach themselves (unless you are on Team Xceler8 already). US and Canada residents ONLY!

First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Facebook Profile URL *
Your answer
Do you have a supportive coach already? *
Are you a coach? *
Tell me how you feel. *
Tell me about your weekly physical activity. *
What types of workouts do you enjoy the most? *
For the love of food! Tell me about your eating habits. *
Tell me what a typical day of eating looks like for you. *
Your answer
Do you take any supplements? *
Do you drink/take anything for energy? (coffee, energy drinks, etc.) *
Stressed Out?! Tell me how you handle stressful days. *
Check all that apply! *
Have you started or completed any Beachbody fitness programs in the past? If so, which ones and how were your results? *
Your answer
Do you have Beachbody On-Demand Streaming access (BOD)? *
Have you used the 21 Day Fix nutrition system before (those cute color coded containers)? *
Select the best answer for yourself about Shakeology. *
What is your age range? *
Which body type depicts you the most right now (NO JUDGEMENT)? This helps me to determine your starting point. *
Body Type Matching
Which image above depicts you the most right now (NO JUDGEMENT)? This helps me determine your starting point.
Your answer
On a scale of 1-5, how would you rate your satisfaction with your body right now? (Be honest. It's ok to want to improve your body, but this group will be helping you improve from the inside OUT!)
I hate it! Don't show me the mirror.
I'm very happy in my own skin and love the way I look.
What do you struggle with the most as far as your nutrition and fitness?
Your answer
What are your health and fitness goals? Having a vision and measurable goals is SO important!
Your answer
Goal Body
Choosing from the image above, what's your goal body? Keep in mind YOUR body type now and what's realistic.
Your answer
WHAT or WHO really motivates you to live a healthy and fit lifestyle?
Your answer
What's your reason for wanting to make changes now? (Think DEEP here --- your kids, health, family...)
Your answer
On a scale of 1 - 10, HOW ready are you to make changes in your life, get amazing results, FEEL amazing AND enjoy INCREDIBLE COMMUNITY while you do it?!
Now I'm scared. I'm not ready.
I was ready yesterday! Lets get started!
Any other information you would like for me to know about you? I'll be in touch within 24-72 hours of receiving your application! Be sure to check the email you provided. I can't wait to get to know you more!
Your answer
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