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A Self Love Approach Coaching Application
All 1:1 coaching and mentoring programmes can be accessed online or in person in Wexford, Ireland.
All programmes have flexible payment plans available - just contact me to find out more!
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Email
*
Your email
What's your name?
*
Your answer
What 3 goals do you want to achieve within the next 3 months?
Your answer
Describe your relationship with your body right now
Your answer
Rate your self belief + self worth from 1-10 (1 being the worst)
1
2
3
4
5
6
7
8
9
10
Clear selection
What would you expect to achieve from working with me?
Your answer
What are your ideal times/days for coaching?
Weekday evenings 4-7pm
Weekend mornings 10-1pm
School holidays/bank holidays
Other:
Clear selection
Online or In-Person?
Online
In-Person (Wexford)
Clear selection
Are you currently receiving treatment for an active eating disorder right now?
*
Yes
No
Other:
Any questions or comments, leave them here!
Your answer
A copy of your responses will be emailed to the address you provided.
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