Welcome

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Apply here for 1-1 Coaching with Rooted Fitness & Wellness
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What is your First & Last name* This field is required.
First Name
Last Name
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What is your Email Address?* This field is required.
example@example.com
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What is your Phone Number?* This field is required.
Please enter a valid phone number.
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What is your instagram? @ or Facebook* This field is required.
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What's your age?* This field is required.
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What is your occupation?* This field is required.
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Tell me about your fitness goals:* This field is required.
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What are the biggest obstacles preventing you from achieving these goals?
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What have you tried in the past? (check all that apply)* This field is required.
HIIT Training
Strength Training
Intermitten Fasting
Keto
Low Carb
Low Fat
Supplements/Meal Replacement
Detoxes
Calorie/Macro Tracking
Custom Meal Plan
Other
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What non-physical goals are you working towards? (check all that* This field is required.
Increase confidence
Increase self esteem
Decrease negative self-talk
Increasing Energy
Educating yourself on how to manage your body
Developing healthier routines
Setting personal boundaries
Time management
Stress management
PREVIOUS
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On a scale from 1-10 (1 being I'm satisfied with where I'm at, 10 being ill do anything to reach my goal) what number are you? * This field is required.
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My programs are about teaching, I tell clients, it's a one-time investment. i'm not the cheapest, but I will solve your problems forever. After the program, you should never need another coach again because ill teach you every thing you will need to know! With that said, are you willing to invest financially to reach your goals?* This field is required.
YESNO
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How would you fund that investment? (You can select multiple)* This field is required.
I would use income from my job
I would use a credit card, or would be open to other financing options
I would use my spouse's income
I would borrow money from someone in my family or circle
I would never invest in a program to lose weight
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Do you share finances with someone that would effect your decision making process to do the program* This field is required.
I can make the decision on my ownI need to run it past someone
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Space is very limited and we want to make sure this is a good fit. Why do you think you would benefit from a call or be a good addition to My mentorship, if invited?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
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Why do you want to work with Rooted Fitness & wellness?* This field is required.
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Large
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Small
Ok
Ok
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AppointmentAfter this call you will receive a welcome email from Rooted Fitness & Wellness including access to My App where you will create your own personal account. You will receive a detail consultation form so I can understand goals and history to match you with the best program for you. You will get immediate access to my app course so you can get started building your knowledge around fitness & nutrition.
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If accepted how soon are you looking to get started? (If you are not ready, please just wait and schedule when you are. I expect those who feel it's a fit to move forward. Those who don't take action are 95% more likely to continue to do nothing).* This field is required.
Now I'M NOT READY
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I realize I am booking in real time with Rooted Fitness & wellness I promise to respect the time by showing up for the time I selected.

you will receive a TEXT to confirm your call with me shortly

Thank you!
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