Work with me one-to-one
Hi there,

I’d love to know more about you!

Please answer the questions below as honestly as possible.

Don’t worry about getting this perfect… There's no right or wrong answer. Just fill it in the best you can without overthinking :)
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Name your friends call you (or whatever you’d like me to call you): *
Your age *
Which article(s) on my website the10principles.com resonated with you the most?
Which of the following thoughts & behaviors describe what you’re going through and approximately how often you do them? *
BTW, I did them all for years and found a way to STOP. You can too! xo
Daily
Weekly
Never
restricting what I eat
bingeing
purging
emotional eating
feeling confused about what to eat
other
Do you do any of these other things?:
select all that apply
Any other preoccupying behaviors?
Which habit is the MOST disruptive in your life? *
Which diets have you tried?
Anything else you want me to know?
How would your life be better if you weren’t preoccupied by food, weight and hunger? What activities would you enjoy more? How would you feel? *
Have you read my book? *
Best day of the week and time for a complimentary 30 minute Discovery Call on Zoom? *
What time zone are you in? *
For example EST, GMT etc... or what country do you live in?
What's your email address, so I can write back to you?! *
What is your favorite way to spend your downtime? Do you have a hobby, sport or other go-to activity or interest? *
I know Kelly’s NOT a doctor *
Required
I know Kelly is basing her support on what she did to make food and weight a non-issue for the last 23+ years. *
Required
Please confirm the following: 1) I understand that Kelly of The 10 Principles cannot provide medical treatment or diagnosis. 2) I understand that Kelly's coaching is not meant to diagnose, treat, or prevent any disease or illness. 3) I understand that I am responsible for my own health at all times, and I am advised and expected to use any coaching in conjunction with (not in lieu of)  professional medical advice. 4) I understand that with any changes in lifestyle, there are certain risks involved, and I take full responsibility for my health and my choices. *
Required
If you haven't heard back within 24 hours, check your junk mail. Still no response? Send me an email via: kelly@the10principles.com. xoKelly ❤️
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