Live Healthy Every Day Application
Hey You!

I'm excited that you're interested in joinging the Live Healthy Every Day program. I'm so excited at the opportunity to be your coach.

The purpose of this form is to give me information about what you want to achieve with a healthy lifestyle so I can help you:
1. Decide if I would be the best coach to help you get there.
2. Set up a preliminary WhatsApp chat to discuss the path forward.

Start by filling out the form below.

Email address *
What's your first name? *
Your answer
What's the best phone number to reach you using WhatsApp? *
Your answer
What goal do you want to achieve with your healthy lifestyle? *
Your answer
What is the biggest obstacle keeping you from this goal? *
Your answer
How do you see your life being different once you've overcome your obstacle and reached your goal? *
Your answer
What are you looking for in an accountability coach? *
Knowing what you're looking for will help me honestly access if you and I would make a good fit.
Your answer
When is the best time to chat on WhatsApp? *
Proposed times are in Central Standard Time (CST) and the WhatsApp Chat is 15 minutes long.
Are you aware that the investment for Live Healthy Every Day is $100 a month? *
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