WELCOME!
Are you a woman in your 30s to 50s who's ready to feel stronger, more confident, and truly at home in your body? My personalized coaching program combines nutrition, fitness, and mindset with spiritual wellness to help you reconnect with yourself from the inside out. Whether your goal is to build strength, improve your health, boost your confidence, or simply feel comfortable in your own skin, you'll receive the support and guidance you need every step of the way.This is your time to prioritize yourself, embrace your journey, and become the healthiest, most confident version of you. I can't wait to support you!
Personal Information:
Name
*
First Name
Last Name
Age
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
How do you want me to contact you?
*
Text
Call
Email
Whatsapp
Telegram
Current Status:
Are you currently divorced or single?
*
Yes
No
How long have you been divorced or single?
*
Goals and Purpose:
What are your main fitness and health goals? (Select all that apply)
*
Weight Loss
Toning and muscle definition
Increased energy and stamina
Spiritual growth and mindfulness
Improved overall confidence
How confident do you currently feel in your body? (Scale from 1 to 5)
*
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
What part of your body are you most confident about?
*
What areas would you like to target? (Arms/Belly/Glutes..etc)
*
Nutrition and Lifestyle:
Are you currently following any specific meal plan? (Yes/No, If yes, please specify)
*
Yes
No
How would you describe your current eating habits?
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Healthy
Balanced
Needs Improvement
Unhealthy
Do you have dietary restrictions or food allergies? (Yes/No, If yes, please specify below)
*
Yes
No
If yes, specify here
Fitness Experience:
How often do you exercise currently?
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Never
1-2 times a week
3-4 times a week
5+ times a week
What types of exercise do you enjoy or have experience with?
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Cardio
Strength Training
Yoga/Pilates
Other
If other, specify here
Spiritual Wellness:
Are you interested in incorporating spiritual wellness into your fitness and nutrition plan?
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Yes
No
If yes, which areas are you interested in exploring? (Select all that apply)
*
Daily Scripture
Meditation
Affirmations
Other
Preferences and Availability:
What type of coaching session would you like?
*
In-Person
Online
Both
What days and times are you typically available for coaching sessions?
*
On a scale from 1-10 How committed are you to your transformation?
*
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
Additional Information:
What specific challenges or obstacles are you currently facing in achieving your fitness and health goals?
*
Any other information you would like to share or questions you have?
Agreement:
I agree to receive communications and updates related to the coaching program.
*
Yes
No
Get Started
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