The Healthy U Application Form
***PRIOR TO SUBMITTING YOUR APPLICATION, PLEASE BE ADVISED THAT THIS PREMIUM COACHING INTENSIVE IS A PAID PROGRAM.

Thank you for you interest in The Healthy U,  1-1 Premium Coaching Program with SheRonda Berry, Holistic Health & Wellness Coach. This is a premium coaching program for women who are ready to take control of their life in the areas of Faith, Food, Fitness, Family, Finances, and Fun.

Completion of this application does not guarantee acceptance into the program. However, if accepted, sessions begin 1 week after payment is received all required forms have been completed and remitted.

Participants will meet with Coach Ron 2 times each month for 30 minutes based on a schedule agreed upon by both parties after acceptance in the program and payment has been received. This program is limited to 5 clients, so all applicants will not be accepted.

If you are invited to join, you will be provided more details on the program, investment, and sessions. If the answers you provided in this application indicate the scope of this program is outside of the parameters needed to assist you, we are pleased to make referrals to outside resources.  
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Email *
Full Name *
Age *
How did you hear about SheRonda Berry? *
Are you familiar with life coaching? *
Have you previously participated in a coaching program? *
If  you answered yes to the previous question, did you accomplish your initial goal during your program? *
If you answered NO to the previous question? What do you  feel prohibited you from accomplishing your goal? If this question is not applicable, answer N/a. *
Why are you interested in this program? *
What are you hoping to accomplish while in this program? *
Are you vegan? *
If no, are you interested in the plant-based lifestyle? *
What is your religious affiliation? *
This is a faith-based program centered around Christianity. Will that pose a problem for you?
Clear selection
How would you rate your relationship with God? *
I do not have a relationship with God
I have a firm foundation in Christ
How would you rate your relationship with FOOD? *
I have an unhealthy relationship with food.
I am well disciplined and use food as fuel.
How would you rate your FITNESS habits? *
I do not exercise.
I am a gym rat or work out queen.
How would you rate your FINANCES? *
I am struggling to get my finances in order.
I have a healthy grip on my money.
How would you rate your relationship with FAMILY? *
I don't care about family dynamics.
Family is everything.
How often do you make time for FUN? *
What is FUN?
I make time for FUN often.
How well do you accept criticism? *
I don't take criticism well.
Feedback is the breakfast of champions.
What areas do you feel you need assistance in the most? *
Required
What area do you feel you need alignment in the most? *
Are you willing to invest at least 1 hours per week over the next 6 weeks working on your holistic journey? *
Your Holistic Healthy U journey requires emotional, psychological, and financial investment. Coach Ron is a dedicated leader who invests high level services to her clients. Are you willing to move forward in the process of making an investment at the end of your consultation? *
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