Be Healthy Be You - The Personalized Weight-Loss Coaching Program

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As part of my high touch, premium, one-on-one weight-loss coaching offering for professional women, I'm looking for someone who is dedicated to improving their wellness game to get healthier, leaner & calmer with self-compassion & less overwhelm.

Please fill out this form to help me assess if the program is a great fit for you. Thanks!

Please share a bit of your story. (For example: What do you do? Why do you want to make a lifestyle change now? etc.) *

What are your personal wellness goals? (For example: How do you want to feel? What are your physical goals? How much weight do you want to lose? What do you most want to achieve? etc.) *

What is your biggest concern when it comes to your wellness? (Pick top response) *

I don’t know how to maintain a healthy weight

I’m concerned about my emotional well-being

I am not able to live the life I want because I can't control myself around food

I get overwhelmed every time I set a health goal

I lose motivation quickly

No time

No motivation to exercise or to go to gym

Other:

What is most important to you in your wellness journey? (Choose one) *

Flexibility and control over my schedule

Meaning and purpose of my life, understanding my emotions

Better health (healthy weight, fit body and lots of energy)

Having a simple weight-loss plan suiting my lifestyle

Accountability, constant support and guidance

Other:

Have you made previous attempts at losing weight or trying to live a "healthier life"? If so, please share your experiences. (For example: What worked? What didn't? What did you love? What did you hate? etc.) Please be specific. *

Why does this time feel like it could be different for you? *

Do you have any unique lifestyle factors that may impact your outcome? (For example- family dynamics, job requirements, food allergies, medical history, any medications you might be taking, etc.) *

What’s preventing you from getting the healthy mind and body of your dreams? (For example: “I just don’t know how to stop overeating or how to understand my feelings.") *

What is your biggest FEAR or CONCERN about your health and wellness? (For example “I constantly worry about never losing the extra pounds", "I worry I will get the diseases like diabetes and high BP that run in my family".) *

Aside from reading books, in what way(s) have you invested in your health/ wellness/ personal development in the past? Please include specifics, including how much money you spent (if any). *

Is there anything else you would like to share about yourself, your story, or your goals? *

Are you ready and willing to make a financial, energetic and time commitment to solving these challenges? If so, why? If not, why not? *

If I am able to give you an exact roadmap to success, are you willing to give me a 'yes' or 'no' at the end of our discussion?
*

Yes

Other:

Please share your name *

Please share your age *

Please share your occupation *

How did you hear about me? *

Please share your city, country and time zone (this shall be helpful while scheduling the coaching calls) *

Please share the best time and day(s) of the week for a complimentary clarity call to discuss if the program is a good fit for you.

(Weekends are fine too!)

Please share your email *

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