Application for Align and Thrive
Please answer all questions as thoroughly as possible.

I will review your application before our call so that we can make the most of our time together.

I look forward to talking to you!
Email address *
How did you find me? *
Your answer
First and Last Name *
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Email *
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Phone Number (or Skype if outside Canada)* *
Your answer
What caused you to be ready to work with me now? *
Your answer
What is the single biggest challenge you are facing right now? Why is it so important for you to solve it now? *
Your answer
What is your #1 Goal that is MOST important to you right now? *
Your answer
What has stopped you from achieving this goal? What is your pattern and or your reasons or excuses? (we ALL have reasons and excuses, so don’t feel bad, you’re human! This is an opportunity to shine some light on what has kept you stuck) *
Your answer
What is struggling with your body and your health costing you in your life? Be specific about how it's affecting your relationships, confidence, money, career, etc *
Your answer
What have you tried in the past to improve your health? Have you worked with a health coach or done a health coaching program before? *
Your answer
What is your urgency for solving this on a scale of 1-10? (10 is high - YES, I'm ready to get the support I need and do what it takes right now, 1 is low - I've got too many things to do, everything else comes first and this always falls last) *
What attracted you to me and my coaching program? *
Your answer
Do you feel you are in a position to comfortably invest in your health and self development now? *
Your answer
How are you currently investing in your health and wellness? (for example: massages, personal trainer, acupuncture, classes etc…) *
Your answer
Age *
Your answer
Location *
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Marital Status *
Your answer
Occupation *
Your answer
Income Bracket *
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