Application for 1:1 Coaching
Before a consultation can be scheduled, an application must be received. Please fill this out thoughtfully, attentively, and in a space that's free from distractions. This is a remarkable step in your journey and I am honored to be a part of it! Congratulations on choosing change! Many people never get here, so the fact that you're here is worthy of praise. When you make a decision and fully commit, the Universe will always have your back. So don't stop now. Keep going. The net will reveal itself once you take the leap! I'm so happy to join you in this chapter :)
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Email *
Are you ready, open to, and willing to make long-term diet and lifestyle changes for the betterment of your health and quality of life? *
Who are you filling this out for? *
Applicant's First Name *
Applicant's Last Name *
Applicant's Age *
Phone Number *
This goes directly to Alexa and is never shared with anyone else. We'll use this to notify you of your Application Status Updates. No promos or spam!
What can Alexa guide and support you on at this time? *
Why Alexa?
How did you find Alexa? *
Which of the following describes your main need for individualized support? (If other, please specify) *
What is your desired outcome through working with Alexa?
Do you forsee anything holding you back from achieving your desired outcome? If yes, please specify.
Are you currently on any prescribed or OTC drugs/medications? If yes, please list the name and what they're for. *
Please list any diagnoses you've received in your lifetime. Next to each one, please notate accordingly (see below):

A = Active Symptoms
N = No Active Symptoms
Are you familiar with Holistic Health?
Clear selection
What is your relationship with God & Spirituality? *
What term do you desire to receive support?
Clear selection
How much of a priority is your Mental and Physical Health? *
Not a priority
My top priority
What is it worth to you to live in a healthy body, peaceful mind, and powerful existence? *
Is the investment cost manageable for you? *
3 Months: 3500 Full Payment
6 Months: 6000 Full Payment
12 Months: 10K Full Payment
12 Months (RA Mentorship) = 12K Full Payment
Payment plans are available!
If your application is accepted, the next step will be a Consultation with Alexa where you'll be able to get your questions answered and concerns heard. If you and Alexa both feel comfortable moving forward at that point, how soon do you desire to get started? *
Is there anything else you you'd like to add?
Submit
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