Nutrition Coaching Application
1:1 coaching is for women who are ready to take their diet seriously and feel that hands-on support and guidance is necessary to achieve their weight loss goals. If you are a good fit, I will help create a personalized plan to reach your goals, address any limiting mindset beliefs and help you achieve a confidence inside and out that you've never had before! 
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First AND Last Name

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Today's Date *
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What is the best email address to reach you at? (*Make sure this is correct as this is how I will be reaching out to you).
What inspired you to fill out this application? *
What is your #1 struggle when it comes to weight loss that has held you back from seeing the success you want? *
When was the last time you actively dieted to lose weight and describe what that looked like and what your results were? *
Describe the vision you have for your body, confidence, and lifestyle over the next few months.  *
Do you suspect you have an untreated ailment like hypo/hyperthyroidism, PCOS, Diabetes, Gut Dysbiosis, Cushings Syndrome, chronic inflammation and cellular damage, insulin resistance, adrenal fatigue, hormonal imbalance, insulin resistance, insomnia, chronic stress and/or depression, an active eating disorder or have been eating an extremely low calorie diet and not seen weight loss results? Please explain. *
The Melissa Maxwell Nutrition Coaching program requires clients to perform some type of food tracking (pictures, app, etc.) to log food. Is this something you are willing to do if you decide to join the program?
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How did you hear about the Melissa Maxwell Nutrition program?

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1:1 coaching requires a minimum 3 month commitment. Melissa has various payment plan options that we will discuss on the call to see what fits your budget. Is that something you're comfortable with?  *
Applicants who are selected to participate in the program will receive an email from Melissa Maxwell melissa@melissamaxwellnutrition.com. Please check your junk mail this week to see if you were selected. *
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DM me on Instagram @the.destinationdietitian - 
"I filled out the application!" 
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