Coach Tara Garrison Client Interest Form

Let's get started!

I would love to help you take your health and life to the next level! Please fill out this form so I can learn more about you and jump on a call with my team to get you all set up. We are dedicated to making this the most incredible health coaching experience you've ever had!
Date*

MonthDay Year
Date
Full Name*

First Name Middle Name Last Name
Birth Date*

Month Day Year
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Preferred Primary Phone*

Area Code Phone Number
E-mail*
example@example.com
Height
Weight
What is your job/occupation?
How motivated are you to succeed on a scale of 1-10?
What are you trying to accomplish in your health/fitness in the next year?
What strategies have you tried to improve your health/fitness that worked and didn't work?
Referred By (how did you find me?)*
Do you have any health issues, disorders, diseases, etc? Please describe.
What is it that most prompted you to take action and inquire about working with me?
Coach Tara's HIGHER Coaching is a high performance program that delivers results. Is it feasible for you to invest $2000+ for coaching if the value was worth it to you?*

Yes
WAIVER

INFORMED CONSENT
I am solely responsible for the decision to see Coach Tara Garrison LLC for nutrition, training and mindset coaching. I recognize that some recommendations may not prove to be successful. I understand some recommendations may be novel. I agree to participate in an active manner, monitor my progress, and report any concerns to Coach Tara or her staff. I also understand that any significant symptoms should be reported to my doctor. It is also recommended that I discuss the use of any nutritional supplements with my doctor before implementing.
Signature*

Signature & Date Clear
Thank you! We will add this to your client file to make sure we provide you with the most powerful solution for your needs and goals.
Should be Empty:

Let's get started!

WAIVER

Thank you! We will add this to your client file to make sure we provide you with the most powerful solution for your needs and goals.