1:1 THM Transformation Application

Name*

First NameLast Name

Email Address*

Age

Are you currently eating on plan?*

What are your goals for weight and wellness with Trim Healthy Mama?*

If you had to list the top two areas where you think you need the most help, what would they be?*

Have you worked with Coach Jen before?*

I (Jennifer Mason Felker) am a Certified THM Lifestyle Coach. I am not a nutritionist or a physician, and nothing I say or publish is intended to be taken as medical advice. Please run all dietary and exercise changes by your physician. (Type "yes" if you agree)*

What is leading you to seek out a Trim Healthy Mama Coach?*

After completing this form, Trim Healthy Mama requires that we have a Discovery Call. 🙂 Do you agree to participate in the discovery call? *

If we decide we are a good fit after the Discovery Call, there is a $75 non-refundable deposit required to hold your spot. This $75 fee will be applied to your total price. Please type "yes" if you understand and agree.*

My 1:1 THM Transformation fee is $425 for six weeks. Payment plans are available. Please type "yes" if you understand and agree.*

Are you willing to download and use the "Ate" app (there is currently a fee, but sometimes you can find coupons online) so Coach Jen can view your meals each day?*

How long have you been on plan with Trim Healthy Mama? (If you're new to the plan, it's totally OK!)*

Do you feel like you are ready to put work in to reaching your goals? Are you willing to take suggestions and make changes?*

After completing this form, you'll be redirected to a calendar where you can schedule our Discovery Call. Please schedule as soon as possible to get the best chance of claiming a spot.

Signature*