Complimentary Clarity Session Intake Form

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Thank you for taking the time to fill out the following questions prior to your Total Transformation Discovery Session. All of your information will be kept confidential.

First & Last Name *

Best Email Address *

1. What is your main area of concern? *

2. What have you done in the past to work on it? *

3. What has proven effective? *

4. What is your current diet like? Please be specific; list breakfast, lunch, dinner, and snacks, as well as the times you eat. (Please answer N/A if you're here for life coaching.) *

6. What would you like your health or life to be 30 days from now? How about 90 days from now? How would you feel if you got this result? *

7. What obstacles, challenges, and struggles do you come up with regarding diet/lifestyle? *

8. What do you hope to get out of our time together? *

9. Why are you so committed to transforming your life right now? *

10. What are 5 things you LOVE about your life? *

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