1:1 Nutrition Coaching Application
Thank you for considering working with me on your health and fitness journey! My 1:1 coaching is designed to help women build strength, achieve sustainable fat loss, and adopt a balanced approach to nutrition, no restrictive diets here. Weightlifting is a key part of the program for building both physical strength and resilience as we work toward your goals.This application will help me get to know you better and see if we’re a great fit to work together. My coaching combines science-backed methods, habit-based tracking, and weekly check-ins, along with ongoing communication to ensure accountability and support every step of the way. If you're ready to approach nutrition with an open mind, commit to the process, and create lasting change, I’d love to learn more about your goals.With over 10 years in the fitness industry and personal experience as a woman over 40. I'm here to help you find strength, confidence, and balance. Let’s get started! Please answer all questions honestly to ensure the best experience possible.
Getting To Know You
Email
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Name
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Age
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Phone Number
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What are your goals ?
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weight loss + balanced nutrition + healthy lifestyle
lose body fat while maintaining muscle
maintain weight but look leaner
create healthier eating habits
gain weight put on muscle mass
Do you have any health conditions (including hormone imbalances, weight loss surgery)
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How much has your weight change in the last year?
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Your Nutrition & Lifestyle History
Have you dieted in the past year? What diets have you tried?
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How many meals are you currently eating per day?
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Are you currently tracking your calories/macros? If so, how much are you currently eating?
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Training & Activity
Which of these best describes your typical day (excluding your workouts)?
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Sedentary: Desk job, mostly sitting, very little walking (under 5k steps).
Lightly Active: On your feet a bit (teacher, pharmacist) or light daily walking (5k–8k steps).
Moderately Active: Constantly moving (nurse, server, busy parent) or high daily walking (8k–12k steps).
Very Active: Physical labor (construction, fitness instructor) or very high movement (12k+ steps).
LIFTING : Do you weight train? How many days a week? How long are your sessions?
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CARDIO: What type? (eg. steady state/HIIT) How many days per week? How long are your sessions?
What do you struggle with most when it comes to your fitness and nutrition?
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How many hours of sleep do you get a night? Is it quality sleep or are you up much during this time?
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Are you open to tracking and lifting weights?
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Yes
No
Maybe
Goals & Mindset (The "Deep Dive")
This is the most important part! This tells me if we are a "mental match" for coaching.
Describe your current relationship with your body and health. What are 2-3 things that frustrate you the most on a daily basis?
The "Future You" Vision: When you imagine the healthiest, most confident version of yourself 6 months from now, what is she doing differently in her daily life that you aren't doing today?
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Identifying Past Hurdles: What is the #1 thing that usually makes you want to give up or feel like you've "failed" in the past? (e.g., social events, slow progress, all-or-nothing thinking).
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Defining Success (Beyond the Scale): What are three "Non-Scale Victories" (NSVs) that would make this program a 10/10 success for you? (e.g., clothes fitting better, more energy, lifting heavier).
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Commitment Level: On a scale of 1-10, how ready are you to move away from "quick fixes" and commit to a sustainable, 3-month body recomposition process?
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Least Likely
1
2
3
4
5
6
7
8
9
Most Likely
10
1 is Least Likely , 10 is Most Likely
Policies & Disclaimer
3-Month Commitment: I require a minimum 3-month commitment to see real physiological changes. Are you ready to commit to this timeframe?
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Medical Disclaimer
I am not a medical professional, and my coaching is not intended to diagnose, treat, prevent, or cure any disease or condition. The information and guidance I provide through strength training and macro nutrition coaching are for educational and supportive purposes only. My services are not a substitute for medical advice from a qualified healthcare provider. I will never make medical diagnoses, claims, or attempt to change treatment plans provided by your physician.My role is to support, guide, and hold you accountable as you work toward your personal health and fitness goals. Always consult with your doctor before making changes to your exercise routine, nutrition, or overall lifestyle.
Next Steps
Thank you for sharing your story with me! I personally review every application to ensure we are a great fit for a successful transformation.
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