The Chronic Wellness Academy Application
Welcome! I'm so glad you're here. This form is to get an idea of what you're looking for from me, as your personal health + wellness coaching. I help people reduce stress and connect with friends and family on a deeper level while living with chronic illness. If that's what you're looking for, and if you're under the care of a licensed, medical professional, please continue on with this application!
Email address *
First + Last Name *
Your answer
Age *
Your answer
How has your experience been with following through with your doctor's treatment plans, or doing the things you know you need to do in order to feel better? (Examples: diet, exercise, reducing stress, or something else [please specify]). *
Your answer
What is your biggest source of stress right now? *
Your answer
How does this source of stress affect your life? *
Your answer
How often do you start something new, but then quit due to overwhelm?
Never, I always finish what I start.
Always, it feels impossible to follow through with anything.
What are you typically overwhelmed by, that causes you to quit? *
Your answer
What's your favorite way to spend time with friends?
Your answer
How often does this ^ happen for you?
Never, it's been over 6 months
Pretty often! I'm happy with the amount.
What would your life look like in 6 months from now if we are successful in coaching? (Think about what goals you'd achieve or how your relationships would be different.)
Your answer
Have you ever worked with a coach before? If yes, please tell me about your experience. (What did you like and not like?)
Your answer
Let's talk finances <3
Why is *right now* the right time to reach your goals?
Your answer
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