Coaching Application for 1:1 Recovery Coaching

Coaching Application for 1:1 Recovery Coaching
Your Name*

First NameLast Name
Your Email*
example@example.com
1. Briefly describe the challenges you’re currently facing with binge eating, addictive eating, sugar, or your health.*
2. How long have you been struggling with these challenges?*
3. Why is it important for you to make progress in your recovery right now?*
4. Have you worked with a therapist, coach, or another professional in the past? If yes, what kind of professional and how was your experience?*
5. If we were to work together, what would you want to work on? What would be your desired outcome?*
6. How do you currently feel (mentally, emotionally, and physically)?*
7. On a scale from 1-10, how serious are you about transforming your life?*

1

2

3

4

5

6

7

8

9

10

1 is Not Very, 10 is Very
8. Are you in a financial position to invest in your health and recovery?*
9. Are you ready to get started now or in the next 30 days?*
10. This coaching process is experientially oriented and may include live guided mindfulness practices, learning self-regulation skills, movement suggestions, discussing abstinent/animal-based nutrition, self-compassion practices, and more. How do you feel about exploring these approaches?*
11. What’s one way you already see yourself as a “badass” in your life, or what’s one big ambition you dream of achieving?*
12. Is there anything else you'd like me to know about you that would help me better understand your journey?*
13. How/where did you find me?*
Should be Empty: