Pre-consultation form
Please fill out and submit this pre-consultation form and I will get back to you as soon as possible to arrange a conversation. The form can take around 15 minutes to complete but it is important that all questions are answered so I have a thorough understanding of your current lifestyle/health situation.
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Full Name
Email Address *
Phone Number *
Occupation *
Who do you live with (alone, family, friend etc.)? *
Tell me about yourself? What brought you here, what matters most to you now?
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What are your current top 3 goals that you hope to achieve next by working with me? What does success look like to you?
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Do you have any competing demands/stressors in life that may slow the progress of your goals? (work/family situations, poor routines/habits etc.)
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Tell me what you think you are good at (nutrition, exercise and/or lifestyle such as morning and evening routines)?
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Do you enjoy any specific sports/activities and are they available to you?
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Tell me about your nutrition history. Have you tried multiple diets, or any at all? Are you aware of what good nutrition involves?
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How many hours a night do you sleep? *
Right now, how much do the people and things around you support health, fitness, and / or behaviour change?
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Not at all supportive
Extremely supportive
I find the most success with my clients when initially putting meal plans to one side and instead focusing on eating behaviours and developing clear goals and positive habits. Is this something that you are willing to try?
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This nutrition journey requires commitment and discipline. We all have setbacks from time to time and that's ok, but success comes from commitment. What is your commitment level to creating a positive change?
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Least Committed
Completely Committed
My programs involve learning and understanding the foundations of holistic health in the form of nutritional education, reviewing success and setbacks, personalised habit/nutrition modifications, looking at progress and reviewing goals (about 30 minutes per week). is this something you can commit to?
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My coaching services are £150 per month for a 3 month commitment in order for us to see proper results. Are you willing to make this financial investment towards your health and nutrition goals? *
If your application is accepted we will schedule a 60 minute call to discuss the process and your goals in more detail. Are you able to commit to this?
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