Elements Wellness Coaching Application Form
The purpose of this application form is to make sure we are a good fit! 

This program is ONLY for serious people who are truly ready to make a change in their lives, bodies, and minds. 

Please only continue booking this call if you’re in a place mentally, financially, and emotionally to commit to a life-transforming program.

Be as detailed and honest as possible- this is a safe, judgement-free space!

Much love,
Leah
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Email *
First Name *
Last Name *
Phone Number *
Instagram handle/Facebook username *
How did you hear about me? *
 What is your #1 problem right now? *
How would you like your life to improve over the next 3 months? *
What stood out to you (maybe a post, something I said) that you made you want to explore working with me as your coach? *
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