Application Form
Thanks so much for applying to work with me, I’m excited to see if we’re a good fit to work together! We need to ensure we are both on the same page so you don’t waste your time or money and I don’t waste my time.

The only way I work with women is in a committed working relationship. This means, I’m committed to you and I will do everything in my power to help you overcome your current health struggles. Likewise, you are committed to the process and what needs to be done in order for us to give it our best shot at getting you your desired outcome. This involves you trusting me and my education and clinical experience that has allowed me to determine the best way to work with clients in order to see results.

You also have to be both financially and emotionally ready to invest in your health. There are no quick fixes and there is a financial investment involved on your behalf.

I'm excited you've made it to this application form and hopefully we'll get the chance to work together to get you moving in the right direction for your health.

Email *
Please answer the following questions and I will review your responses & be in touch to suggest how I may be able to help you.
What is your name and where are you located, (I work 100% online so it doesn’t matter where you live in the world). *
What is your age? *
Are you currently pregnant or breastfeeding? *
What is your main health concern(s) that you would like me to help you tackle? Please list the top 3 that are the priority for you right now. *
What have you tried in the past to get on top of your health concern(s)? Were you successful in your attempts? If not, why not? *
Why do you believe you haven't yet been successful in freeing yourself from your current health struggles? *
Do you consume a vegetarian or vegan diet currently? *
If you DO consume a vegan or vegetarian diet, are you willing to start to introduce some animal protein? *
How committed are you to making the changes I may suggest for you? For example, I will tell you to go gluten-free, reduce your sugar consumption, and limit or eliminate alcohol whilst we work together. I will guide you every step of the way and give you support and tools to make these transitions easier for you, (you won’t be in this alone) but you have to take personal responsibility and come to the party too, so to speak. I won't let you succumb to your own excuses, so on a scale of 1 - 10, with 10 being the “most committed”, how ready are you to make a change in your health and follow the protocol(s) I suggest for you? *
Least committed
Most committed
How much support do you you need to make a change? Are you someone who likes to have weekly check-ins with your coach, or are you someone who likes to do things a little more "solo"? Do you want some ass-kicking from me or do you want to go at your own pace a bit? (Either is completely fine - this just helps me determine which of my programs would be a better fit for you). *
How much money do you estimate you've spent on your health journey so far? *
How much are you willing to invest in your health at this time? Please note I do offer payment plans when necessary and obviously my higher priced packages come with a significant amount of support from me. *
How did you hear about me? *
Thank you
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