Health and Lifestyle Coaching Discovery Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please fill out and submit this form at least 24 hours before your consultation.

Please provide as much detail as you feel comfortable sharing. This allows me to learn
some important things about you before we talk, so that we can spend most of our time discussing what's important to you, and I can set aside time to think about the most effective ways I can coach and empower you to achieve your vision.

*Health & Lifestyle coaching consultations are only for people exploring working together in an ongoing coaching partnership. If you booked this hoping for a one off coaching session, please cancel this appointment immediately.

This form auto saves allowing you to come back if you need to finish it later.

Email *

Name *

Phone Number *

How did you discover my business? *

How come you choose to contact me specifically?
*

Have you experienced health and lifestyle coaching?
*

Yes

Required

What was your experience like?
*

Have you had an experience working with a health coach that made you feel uncomfortable or unsafe? If yes, please share anything that you feel is important for me to know.
*

Specific Health Struggles

What Specific health struggles have been frustrating you?

What are your health struggles *

I got some extra body fat that I'd like to lose

Struggle to preserve my desired weight and body image

Take a long time to fall asleep

I wake up often at night

High resting heart rate

High blood pressure

Improving my blood lipid panels

pre-diabetes or type II diabetes

Persistent Diahrea

Heart Disease

Cardiovascular Disease

Osteopenia

Other:

Required

How come it's important to you to overcome these health struggles? *

How come you are reaching out for coaching support now?
*

What things have you tried in the past that were successful at helping you with your current struggles? *

What things have you tried in the past that weren't successful at helping you with your current struggles? *

How do you envision that I could help you overcome what you're struggling with?
*

What expectations would you like me to meet or exceed if you decided to hire me as your health and lifestyle coach?
*

Is there anything else that you'd like to add or discuss that is important to you?

Clear form

Never submit passwords through Google Forms.

This form was created inside of Life Strength Fitness. Report Abuse

Forms