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Working Together - Inquiry Form
Hello!
Thank you for reaching out.
Please kindly fill out the following questionnaire to discuss working together.
* Indicates required question
Email
*
Record my email address with my response
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
How did you hear about me? (health practitioner, podcast, TikTok, IG, YouTube, client, friend)
*
Your answer
Tell me about your current state of health.
*
Your answer
What have you tried in the past?
*
Your answer
What is stopping you from achieving your goals?
*
Your answer
How committed are you to your healing journey?
*
I'll do whatever it takes! I love to empower myself.
I am committed. I just need mindset coaching to get me there.
I am resistant to change and "cherry pick" what I will and will not do.
Other:
What level of support are you most interested in?
*
1:1 health coaching (this is a high-ticket custom experience)
Self-paced programs (low to mid-tier cost)
Low-cost to free support
Assuming we are a fit, do you have a budget for a high-ticket 1:1 health coaching experience?
*
No - I can't invest in a program.
Yes - I can invest in a program.
How soon are you looking for help?
*
ASAP
0-3 months
6+ months
Health is a time commitment as well as an investment. On a scale from 1-10 (10 being the highest), how important is changing your health?
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1
2
3
4
5
6
7
8
9
10
Anything else you would like to share?
Your answer
Once submitted, please allow 24-48 hours for a response sent to the email provided.
Be sure to check junk/spam folders.
Thank you for your interest in working together!
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