Coaching Application Form

To confirm, you are filling this out because you want to lose between 10-25 lbs of stubborn fat, regain energy, optimize hormones, build lean & toned muscle + make this the LAST PROGRAM you'll ever need?* This field is required.

YES - I am serious, and want to learn more about reaching my dream body, without sacrificing my life.

NO - I'm going to leave this page immediately.

What's your First Name?* This field is required.

What's your Last Name?* This field is required.

What’s your age?* This field is required.

Which of the following best describes your goal with The Cortisol Balance Blueprint?Choose as many as you like.

I want to lose between 10-25lbs of stubborn fat in the first 12 weeks, regain the energy I once had, and feel comfortable and confident in my own skin.

I want to restore my hormone balance and feel more in control of my body.

I want to lose some weight and feel more confident in my skin + regain a healthy relationship with food.

I want to ditch tracking macros and find something easier and sustainable.

I'm not exactly sure what my specific goals are, but I do know my approach to nutrition, fitness and health is not working the way I would like them to.

I am a coach myself, and I understand coaches need coaches. I'm hoping to learn from your qualified staff so I can better serve my clients.

I have no clue, but I know I need to invest in my health, and personal growth.

What is your current occupation and how long have you been doing it?Work environments have a huge impact on stress, and therefore weightloss. This helps us understand what kind of obstacles we'll be up against.

Do you have a significant other? If so, are they supportive of you potentially investing in your weight loss, health and personal growth?

Yes, I have a significant other and they are very supportive.

Yes, I have a significant other but this is my decision to make.

Yes, I have a significant other but they may need to be on the call with me to make a joint decision.

No, I'm single AF and make my own rules, lol.

Last Question! If you were to find a way to reach your dream body, optimize hormonal function, and learn how to keep your results for LIFE, making The Cortisol Balance Blueprint the last program you'll ever need to join - would you be willing (and able) to invest in getting the help necessary to get there?* This field is required.

Yes, I have the cash flow to invest in myself.

Yes, I may or may not have the cash flow, but I'm resourceful and / or have access to credit.

No, my cash flow is month-to-month and I have no access to credit.

What is your Email Address?* This field is required.So, we can hook you up with some free resources after our strategy session.

example@example.com

What's your Phone Number?* This field is required.Please confirm your mobile number ( It's really important this is correct so that we can confirm your application + help you book your strategy session )

Please enter a valid phone number.

What is your Instagram handle to reach out with any follow up questions @ ?* This field is required.

Coaching Application Form