Application to Work with Sheila
Please answer all questions as thoroughly as possible.

All applications are reviewed personally by Sheila. Applications are sorted according to order received, and those that are most qualified will get noticed first.

You will receive a reply within 48 hours (Mon-Fri) to schedule our one on one conversation to discuss your specific needs and determine the next best action step for you.

First and Last Name
Your answer
Best email to reach you
Your answer
Phone Number (or Skype if outside the US)
Your answer
What caused you to be ready to work with me now?
Your answer
What is the single biggest challenge you are facing right now? Why is it so important for you to solve it now?
Your answer
What is your #1 GOAL that is MOST important to you right now?
Your answer
What has stopped you from achieving this goal? What is your pattern, reasons, or excuses?
We ALL have reasons and excuses, so don’t feel bad, you’re human! This is an opportunity to shine some light on what has kept you stuck.
Your answer
What is this struggle COSTING you in your life?
Be specific about how it's affecting your relationships, confidence, money, career, etc.
Your answer
What have you tried in the past to improve your health? Have you worked with a health coach or done a health coaching program before?
Your answer
What is your urgency for solving this on a scale of 1-10?
10 is high - YES, I'm ready to get the support I need and do what it takes right now, 1 is low - I've got too many things to do, everything else comes first and this always falls last.
Lowest
Highest
What attracted you to me and my coaching?
Your answer
How did you learn about me?
Your answer
If we get on the phone and what I have to offer is what you say you need, will you be 100% ready to take INSPIRED ACTION and invest in yourself at that time?
Your answer
How are you currently investing in your health and wellness?
For example: massages, personal trainer, acupuncture, fitness classes, alternative health doctor, chiropractor, etc.
Your answer
Age
Your answer
Weight
Your answer
Height
Your answer
Location
Your answer
Marital Status
Your answer
Occupation
Your answer
Income Bracket
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms