New Client Application!
Are you a divorced or newly single woman in your 30s to 50s who wants to feel empowered, confident, and comfortable in your own skin? Our personalized program blends nutrition, fitness, and spiritual guidance to help you reconnect with yourself, embrace your body, and feel confident naked. Whether you’re looking to tone up, improve your health, or find peace and clarity within, this is your time to shine. Join us and start your journey to a stronger, more confident 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
Current Status:
Are you currently divorced or newly 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?
*
Nutrition and Lifestyle:
Are you currently following any specific meal plan? (Yes/No, If yes, please specify)
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Yes
No
How would you describe your current eating habits?
*
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?
*
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?
*
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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