Nutrition Coaching Application
Thanks a mill for the interest in signing up for online nutrition coaching.

Before we get started it is incredibly important to state my scope of practice. I prescribe exercise and give nutritional information in terms of promoting general health. I cannot, and do not treat medical conditions.

I also cannot help if a person if suffering from an eating disorder.

Symptoms of eating disorders include:

- spending a lot of time worrying about your weight and body shape
- avoiding socialising when you think food will be involved
- eating very little food
- making yourself sick or taking laxatives after you eat
- exercising too much
- having very strict habits or routines around food
- changes in your mood such as being withdrawn, anxious or depressed

You may also notice physical signs, including:

- feeling cold, tired or dizzy
- pains, tingling or numbness in your arms and legs (poor circulation)
- feeling your heart racing, fainting or feeling faint
- problems with your digestion, such as bloating, constipation or diarrhea
- your weight being very high or very low for someone of your age and height

If you have any of the symptoms listed I recommend you contact your GP.

By signing up you understand the conditions under which we will work together and the fact that medical treatment is not within my scope of practice.

Here a few questions I need you to answer to understand what your goals are and to see if I can help you with my coaching services.

Sign in to Google to save your progress. Learn more
€149 per month.
Name *
Date of birth *
Email address *
Where do you live? (country of origin) *
What is your gender? *
What's your favourite TV series or movie and why do enjoy it so much? *
Do you have any hobbies/interests or favourite things to do? Do you follow any sports teams or have a band you love? *
Where did you hear about my coaching services? *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy