Keto Elite 1-1 Nutritional Coaching Initial Intake Form
Your time to start your journey is now, if you are willing to commit please fill out these questions in as much detail as possible.

Fill this form out to learn more about you and about your goals. We look forward to working with you!
What is your First and Last Name *
What email would you like to be reached at? *
What is your phone number to set up our first call? *
Check all the Reasons You Want to Apply for Keto Elite's Transformation Coaching? *
Are You Prepared to Invest in Yourself? *
What is your Current Weight? *
What programs have you tried in the past that have not worked? *
Have you tried keto before and if so how long did you stick to it? *
What is your Instagram Handle?
What are you looking for in a coach? *
Are you positive you will show up for our phone call (once we schedule a time) *
What are barriers that get in the way from you losing weight? *
Why do you think you need a one on one keto coach? *
What is holding you back from achieving your goals? *
Keto Elite Coaching Program is $297 per month, are you willing to invest in that for your health? *
How many months can you commit to coaching? *
And thats it! I will send you an email in 24 hours or less and we can set up a time to have our free screening call to see if you are a good fit! Look forward to helping you achieve your goals!
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