VIP Coaching Application
To apply for VIP Coaching please complete all questions.
Section 1: Nice to meet you!
Name
First Name
Last Name
IG Handle
E-mail
Cellular Number
-
Area Code
Phone Number
Gender
Occupation
Tell me what a typical day looks like for you?
If you have any health considerations [thyroid, diabetes, PCOS, or other auto-immune or chronic illness] please share here.
Section 2: Let's chat about your lifestyle & goals!
Please select areas that you struggle with [nutrition + training]
Social pressure with friends/family to eat/drink a certain way
Social pressure at work to eat/drink a certain way
I struggle dining out & choosing foods that leave me feeling satisfied but not guilty
I'm not sure how often to workout or what to do
I don't have a game plan for workouts, I just wing it.
I struggle to find time for my health + fitness
I struggle with body image more often than not
I have missed out on events & experiences due to being self-conscious of my body.
Please select areas what you struggle with [biofeedback + health]
Chronic fatigue and/or inconsistent sleep
Gut discomfort + bloating
Known gut issues [IBS, SIBO, disbyosis, etc]
Mid-day energy crashes
Wired & Tired in the PM [you know you need to sleep, but you can't fall asleep]
Brain Fog
Chronic Pain
What goals do you hope to achieve through VIP Coaching?
Weight Loss
Muscle Gain/Strength Gain
Toning Up
Weight Gain
Food Freedom
Improved Body Image
Hormone Healing
Gut Healing
Current behaviors/mindset you struggle with:
Body Image
Food Choice
Meal Prep
Binge Eating
Lack of Time
Scale Stress
Event Avoidance
Hungry but scared to eat more
Gym intimidation
Have you worked with an online coach before?
Yes
No
Section 3: Just a few more questions!
On a scale of 1-5, how committed are you to your goals?
1
2
3
4
5
VIP Coaching is a minimum 5-month commitment, with many client staying on 9+ months. Are you willing to commit the minimum window of time for coaching?
Yes
No
Are you prepared to invest $300-$375/mo toward your health & wellness to be the best version of yourself?
*
Yes
No
I'd be interested in financing for a long-term commitment [6+ months]
VIP Coaching is a minimum 5-month commitment, with many client staying on 9+ months. Are you willing to commit the minimum window of time for coaching?
Yes
No
How did you find out about VIP Coaching?
Instagram
Facebook
Current or Former Client
How would you prefer me to reach out to you?
Email
Instagram DM's
Phone Call
Text message
Zoom Call
Apply for Coaching
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