Coaching Application
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Hello! Thank you for taking the time to submit this application to my online coaching program. Once you've filled out the form below, I will contact you to discuss next steps. There are no "right" or "wrong" answers to any of these questions, and zero judgement of your responses. This just helps me get a better understanding of where you are right now and if my program will be a good fit for you :)
First/Last Name *
Primary email address (no spam, promise!) *
What is your main reason for wanting to join my program? E.g. what's your biggest goal/health challenge that led you to seek coaching? *
What made you decide that *now* was the time to take this step and apply?
On a scale of 1-10, how READY are you to commit resources (time, energy, money) to improve your health and wellness? (Ready = how prepared are you to take action right now?)
Clear selection
On a scale of 1-10, how WILLING are you to start making changes to your health and wellness? (Willing = having an open mind, willing to engage/participate in the coaching process) *
On a scale of 1-10, how ABLE are you to make changes at this time? (Able = you have the bandwidth, energy, & resources to put towards this process) *
What do you feel is your biggest barrier to change right now (what is currently keeping you from reaching your goals)? How is that particular barrier getting in your way? 
New client packages are for a minimum of 3-months, starting at $1499 (price varies depending on payment plan). Are you in a place to invest your time and finances to reach your goals?
Clear selection
Imagine it's the future and you've just completed 3 months of coaching: what's changed? How does your life look different? (E.g. how do you feel physically/mentally? What are you doing - or not doing - on a daily basis?)
Is there anything else that you'd like me to know? Maybe a fun fact or interesting thing about you?
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