Nutrition Coaching Application

Program Application

Congrats! The fact that you've even here means that you care about your health, happiness and relationship with food to look into coaching. This application is an opportunity for me to see if and how I can help you reach your goals in a healthy and sustainable way that fits YOUR lifestyle. I only take on clients who are willing to put in the work and eager and willing to adapt this as a healthy lifestyle and not a quick fix. Please fill out the form below - I will review it and reach out to you within the next 48 hours.
Name*

First NameLast Name
Email*
example@example.com
Gender*

MaleFemale
Date of Birth*

MonthDayYear
Date
If you were referred by someone, please tell me here:
To learn more about YOU, your goals and your history:
Tell me about your goals! I want to know what you are looking to accomplish through coaching with me. No goal is too big or too small.*
What is your big WHY (why are these goals important to you)? *
Until now, what has held you back from achieving your goals? *
What (if any) diets have you tried in the past? What were your results? What were your struggles? *
What does your current eating routine look like? *
What makes you already want to have Kollie as your coach?*
Have you worked with a coach on your nutrition or fitness before?*

YesNo
Which of the the following do you struggle with?*

AccountabilityKnowledge of nutrition / macronutrientsStaying focused on weekendsMeal prep / planningTime managementSupport from family & friendsKnowing if what you are doing is right to meet your goalsWorking out consistentlyOther
Explain your current fitness / exercise routine.*
1:1 coaching is an investment in yourself to learn tools & build habits that fit your lifestyle & last a lifetime. Are you ready & willing to make a financial investment in yourself to improve your mindset & body image, build a better relationship with food, reach your physique goals, and learn how to properly fuel your body?*

I don't know if I am ready to make this kind of investment, but I am curious to learn more.YES! I am ready & able to make this investment to reach my goals, improve my mindset and reclaim my health!
Thank you for taking the time to fill out this application. My goal is to teach you the tools you need to feel empowered and confident in your health & nutrition!
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Program Application

To learn more about YOU, your goals and your history:

Thank you for taking the time to fill out this application. My goal is to teach you the tools you need to feel empowered and confident in your health & nutrition!