Apply to work with me

Apply to work with me
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Tell me a bit about your goals. Where do you want to see yourself, your health, or your weight in 6 months? (Be as specific as possible)*
On a scale of 1-10 how committed are you to accomplishing those goals?*
What led you to filling out this application today?*
Would you consider yourself open-minded, willing to learn, and willing to try new things?*

YesNoNot sure
Have you ever worked 1-1 with a coach before?*

YesNo
What are you currently struggling with most, or what is your biggest obstacle to your goals?*
What have you tried before that has NOT worked for you?*
What do you feel you need help with the most?*

Weight lossLow energy throughout the dayAccountability/staying on trackFiguring out what foods work best for meMeal planningRelationship with foodSugar addictionBody imageOvereatingEating healthy as a family
Choosing to invest in yourself (time, energy, finances) is a declaration that you are worth growing & improving. Are you in a position to invest financially in yourself and your health?*

YesNoMaybe
How did you find me (Coach Leah Harvey and LivliCo.)?*
Anything else you would like to share?*
After you submit, you will receive an email to book a quick call with Leah to discuss your application. This is a no-pressure conversation, simply to chat together about your potential, and to find out if coaching is the right option for you right now.

(If you do not see an email within 24 hours, please check your spam folder.)
I am prepared to move forward*

By checking this box, I acknowledge that if I set up a next-steps phone call with Leah, I will show up and be on time for the call. I value and respect the time of others and don't wish to waste the time of Leah, other serious applicants, or Leah's current clients who are also booking with her.
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