Health Mentorship Application
Please note submitting this form does not obligate you to purchase anything...just ensures you get more out of our first conversation about mentoring regardless of whether or not you choose to move forward😉
Name (First and Last)
Which of these issues are areas where you'd love to see improvement? (Check all that apply.)
Daily Energy levels
Weight loss/fat loss
How would you describe your current fitness level?
Beginning -- I'm not working out at all or just recently started working out.
Intermediate -- I consistently work out 3-5 days/week.
Advanced - I consistently work out 4-6 days/week.
How many days per week would you be willing to exercise?
Would prefer to focus on nutrition ONLY to start
How much time each day could you set aside for your fitness? (Skip if you chose last answer above.)
When it comes to nutrition where are you most challenged?
Breakfast - I can never seem to make time for a decent meal.
Lunch, I'm always on the go, which leads me to the drive-thrus.
Dinner, I struggle to find meals that are healthy AND that my family enjoys.
All day. I'm a snacker and I graze all day.
All of the above. The struggle is real.
At the end of 2019, what do you want to say you accomplished in regards to your health and fitness?
What do you feel you want/need most from me as your health coach?
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