1-on-1 Coaching Questionnaire
Please fill this out with 100% honesty and as much detail as possible.  These answers are completely confidential and will help me determine if we are a good fit to work together!
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Email *
Name *
Occupation
Age
Which describes you best right now? *
Required
How do you feel about your body?  Not what you think you should feel or what you think others should feel, how do YOU feel about YOUR body? *
What are 3 physical goals you have? (lose X amount of weight, lift more weight, fit into X size jeans, etc)
What are 3 non-physical goals you have? (more positive mindset, find morning routine, get into healthier habits, read more books, etc)
What are your top 3 priorities in your life right now?
What have you been struggling with? Check all that apply.
What are typical things you think to yourself when you look in the mirror? *
Do you currently have a daily journaling/gratitude practice? *
What habits (if any) do you want to kick?
What have you tried in the past to reach your goals?
On average, how much water do you drink per day?
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On average, how much sleep do you get per night?
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What does a typical day of nutrition/meals look like for you?
What is your current relationship with exercise?
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What do your current workouts mostly look like? (if any)
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Describe your dieting history.
Current overall stress level?
Little to no stress
Extremely/overwhelmingly stressed
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Why is it important for you to reach your goals?
How do you think I can help you reach your goals?
What typically motivates you?
How did you learn about my 1:1 Coaching Opportunity? *
If I told you my 1-on-1 coaching was $300/month (this is not the price), what would you say?
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