Application - Weight Loss Coaching
Complete this application for 1:1 weight loss coaching for women over 35. It should only take 10 minutes to complete!

Please only apply if you are a serious applicant. This program is an individualized 6-month total transformation and a long-term, sustainable solution.

The total lifestyle transformation program includes nourishment, education, mindset, lifestyle habits, stress management etc. If you are not ready to commit the time, energy and space to the process, I recommend you apply at a later date.
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Name *
Phone (I will call you at this number unless you are international) *
Email *
Age *
How much weight do you have to lose? *
What nutrition programs or diets have you tried in the past and what were the results? *
What are your biggest struggles when it comes to healthy eating? Please check as many as apply. *
Required
Have you lost weight in the past? *
If you lost weight in the past, what do you think caused the weight to come back? *
What obstacles or things do you think are getting in the way of losing weight? *
What's your current activity level? Please tell us about your exercise routine (i.e. type of exercise, duration, days per week). Please be specific. *
How does being overweight limit your life? What activities or opportunities are you missing out on? *
What do you think it is costing you financially every month NOT to feel healthy, fit and confident in your body? What do you think are the total costs of all the opportunities, raises, clients, and personal activities you’re missing out on? Be sure to include missed life experiences as well as medical and cosmetic costs. *
How committed are you to getting help now so you can finally lose the excess weight? (note: this has nothing to do with my program - this is your personal commitment to change your situation) On a scale of 1 to 10 with 10 being super committed: *
Not Committed
Super Committed
What do you REALLY want to achieve going through coaching? *
What do you think is holding you back from your goals? *
Are you willing to do the work necessary to get to the other side, EVEN if it gets uncomfortable at times? *
On a scale of 1-10: 10 being a life you LOVE, feeling amazing; 1 being miserable and barely surviving each day….Where are you right now? *
Miserable
Love
What amazing things would happen if you finally lost the weight and felt 10/10 amazing? *
What motivated you to schedule this call? *
What makes you a great candidate for weight loss coaching and why should you be selected? Please note - I do not accept all applicants into the program. *
Do you promise to show up for your consultation free of distractions, NOT driving, at the store etc.? If you cannot make your time PLEASE reschedule in advance. *
Have you watched my free weight loss class for women over 35? If you have not, I HIGHLY recommend you watch the class: https://skinnyfitalicious.com/hormonal-weight-loss-class/ *
Do you listen to my podcast the Dish on Ditching Diets? If you do not listen to my podcast, I highly recommend you do this prior to our call: https://skinnyfitalicious.com/podcast/ *
Is there anyone else who needs to be on the call for you to make a financial decision? Does your partner need to approve of you getting the help you need?  *
I understand that by not investing in myself, I am choosing to stay in the place I am uncomfortable in and I understand the cost to my mental state, my family and my health of not taking action. *
I understand the consultation is to discuss my goals and if the 6-month 1:1 coaching program is a fit and that it is NOT to provide specific nutrition or exercise advice. *
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