Habits + Heartwork 1:1 Coaching Application
This questionnaire should only take a few minutes to complete. Consider it your first step in seeing the change you want to make in your life!

My 1:1 coaching programs requires a minimum commitment of 3 months in order to allow you the time that is needed to build lasting habits and experience long term change.  Working 1:1 with me is very individualized and much of the change you will experience will not be visible to others.  Meaning, it is unlikely that you will see a total body transformation in three months time because we work on building the right mindset and habits that are going to allow you to build a healthy lifestyle long term. This will eventually allow you to experience the physical transformation that you and your body can realistically sustain because it's in alignment with your natural tendencies and preferences and your unique physical make up. 

If you are looking for a quick fix, or someone to give you a set of rules to follow in order to reach a specific number on the scale, I'm likely not the coach for you. 

If you are not willing, ready, or able to commit yourself to this process, please wait and apply later when you are ready. 




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Email *
Email *
First Name *
Last Name *
Instagram handle
Phone Number *
Age *
Gender *
Occupation *
What are your goals? Please be as specific as possible (i.e. lose weight, look and feel better, build healthier habits, improve health, etc) *
What are your biggest struggles when it comes to healthy eating? Please check all that apply.  *
Required
What nutrition programs or diets have you tried in the past?  *
Of those programs, what worked well for you or what did you like about them? *
Of those programs, what did NOT work well for you or what didn't you like about them? *
Have you tracked or logged your food in the past? *
How did that work for you?  *
Do you have a diagnosed health problem? If so, please elaborate as much as you feel comfortable.  *
Are you currently pregnant, breastfeeding, or trying to conceive?  *
How do you think your life will improve by working with a coach?  Be specific.  *
What is standing in the way of you making the changes in your life that you want to make?  *
What is standing in the way of you making the changes in your life that you want to make?  *
What are your expectations of me as your nutrition coach?  *
How do you best respond to coaching and accountability?  Do you respond well to constructive criticism/tough love, or do you prefer a softer approach?  What motivates you? *
As a believer, I regularly share my faith and how life-changing prioritizing a relationship with Jesus is. Is this something you are open to?  *
Why do you want to work me versus a different coach?  *
How committed are you to putting in the work to make the changes you want to make? *
I really want to change, but life is just so crazy I don't have the time.
I am absolutely ready for change and I am willing to give it everything I've got to make it happen.
Individualized coaching requires a three, six, or twelve month commitment. Are you ready, willing, and able to commit to at least three months?  *
Individualized coaching requires a financial investment starting at $350. Are you ready, willing, and able to invest in yourself?  *
How did you hear about Habits + Heartwork? *
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