Apply to work with Michelle

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Please complete this brief application to help determine if you're a good fit for my 1:1 coaching program. You will receive a response within 48 hours.

Email *

Name *

Phone Number *

Age *

What would your availability be for coaching appointments? (Time zone below is PST)

Mornings (7am-11am)

Afternoons (12pm - 4pm)

Evenings (5pm - 7pm)

Saturdays (7am - 11am)

I'm flexible

Briefly describe your current symptoms, concerns and/or struggles as it relates to your health. *

What have you already tried to resolve these problems? *

How are these issues holding you back from your life, career and aspirations? *

Why is now the right time for you to address these issues? *

Do you think friends and family will be supportive of you making changes to improve your health and lose weight? *

Yes

Unsure

How committed are you to making these changes? *

Not committed

Very Committed

Michelle, if I am selected and decide to work with you, I’ll find a way to invest in myself and my future:

I have the necessary means to invest in my health and future

I have the ability to get the necessary means to invest in my health and future

I have no financial means to invest in my health and future

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A copy of your responses will be emailed to the address you provided.

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