New Client Form

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New Client Form

Thank you for your interest in coaching. It is my mission to help as many food-lovers as possible experience full freedom around food. In order to help you best reach your goals, please answer the following questions for me. That way I can understand your specific needs and whether my program is the right fit for you. I appreciate your honesty. Please return it before your free coaching session.

Email *

First name *

What is your main goal for yourself? *

Weight Loss

Drink Less Alcohol

Better overall health

Stronger body

Other:

Explain more about your goal below.

What is your biggest struggle with overeating and weight loss? *

Knowing where to start

Getting motivated

Seeing results

Portion control

Having a specific plan

Other:

What is your current height and weight? *

What does a typical day of eating/drinking look like for you now? *

How active are you on a daily basis? *

Little to no exercise

Moderate exercise (like walking a few times a week or low-intensity aerobics)

Regular exercise (cardio or weight training at least 5 days a week)

Rigorous exercise (high intensity cardio or weights for 60 minutes + most days)

Other:

What foods feel good in your body? *

What foods/drinks do you struggle with over consuming? *

What is your goal weight or ideal relationship with drinking by the end of this program? *

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