One on One Coaching with Amanda

Health Breakthrough Application

Welcome! I'm so excited you've landed here. Let's see if we're a good fit, shall we? :)
READ BEFORE YOU APPLY

Filling out this application will put you into a waitlist to work with me.

If we work together, you will be challenged to both receive the results you desire and transform your body and mind to be the best version of yourself.

The whole goal of my Health Breakthrough Program is to get results. Period.

**If you are approved, you’ll receive an email confirmation and a link to schedule an interview Zoom call with me to dive deeper. **
Full Name*
Type in your full name
Email*
example@example.com
Phone Number *

Area CodePhone Number
What are you health and fitness goals in the next year? -- be as detailed as possible*
On a scale of 1-5 how important is it that you reach those goals -- 1 not important, 5 very important*
Be honest, what do you feel has held you back from achieving these results on your own? -- Be as detailed as possible*
Why is NOW the time that makes sense for you to work with a coach?*
What drew you to want to work with me, specifically?*
If it turns out that we are a great fit to work with one another and I accepted you as a client, are you at a place in life where you are committed and able to invest in yourself both emotionally and financially to achieve these health goals?*
Should be Empty:

Health Breakthrough Application