Lifestyle Coaching Application
With Dr. Michelle Hamilton
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
What are your goals for 1:1 coaching?
What would happen if you don’t achieve those goals?
What is your current diet? Give an example of what you ate today.
What is your current exercise regime?
Do you have any injuries that would prevent you from exercising?
Do you take any medications or supplements? Please list below.
What is the biggest thing stopping you from reaching your goals?
Have you ever tracked your food on a day to day basis?
Are you willing to track your food everyday to achieve your desired results?
Anything else you’d like Dr. Michelle to know?
Submit
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