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Longevity Health Coaching Application
Thank you for your interest in working with me! Please complete this short information form.
*Please Note: I am only accepting clients from the US and Canada.
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First & Last Name, Email Address
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Your answer
Please share a bit about your current health challenges:
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Your answer
What are you looking to achieve from coaching?
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Your answer
Have you worked with a coach before? If yes, what was your experience like?
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Your answer
Improving your health (and/or your healing) requires time, effort, patience and commitment. Are you willing to put in the effort it takes to heal?
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Yes, I'm ready!
I'm hesitant.
Improving your health (and/or your healing) is an investment, not an expense. Are you ready to invest in your health?
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Yes, 100%.
Unsure.
Is there anything else you would like to add so I have a clear understanding of what you are looking for?
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Your answer
Thank you again for your interest in working with me! I'll be in touch once I review your application. Talk to you soon!
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