Nutrition Coaching Application

Nutrition Coaching Application

Let’s take the confusion out of food and build habits that last. Please complete this short application so I can learn more about your goals and see if my personalized nutrition coaching is the right fit for you. After you submit this form, you’ll be directed to book your free 20-minute consultation call.
Basic Info
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
How did you hear about Reclaim Fitness Studio?
Goals & Habits
What are your top 1–2 goals when it comes to nutrition?*
(e.g. lose fat, improve energy, eat more protein, feel better in my clothes, stop emotional eating)
What’s your current eating style like?*
(Tell me a little about what a typical day of eating looks like)
Have you tried any specific diets or nutrition plans in the past?*
(What worked? What didn’t?)
Which Option Best Fits you?
I offer three levels of nutrition support. Please select the one that best fits what you're looking for right now:

Premium Monthly Package (Fully Remote)
– Personalized nutrition coaching
– Habit building + food journaling
– Macro education (with tracking support)
– Video recipe walkthroughs & monthly recipe guides
– Unlimited messaging + private coaching calls

Standard Nutrition Package (General Guidance & Accountability)
– Basic habit coaching
– Meal photo feedback
– 2 check-ins (in-person or virtual)
– Unlimited in-app messaging

Single Nutrition Consultation (One-time, 45-Minute Virtual Session)
– Personalized assessment + advice
– Macro breakdown PDF
– Tailored guidance based on your current goals
Which option are you most interested in?

Premium Monthly PackageStandard Nutrition PackageSingle Nutrition Consultation
Commitment
Are you ready to start building healthier nutrition habits in the next 30 days?*

YesI'm gathering infoNot quite yet
Is there anything else you'd like me to know before we chat?
Thank You For Applying

Thank you for sharing your goals and taking the first step toward building a healthier, more confident you. After hitting the submit button, you will be directed to book your free 20-minute nutrition consultation so we can connect, talk through your goals, and see if this coaching program is the right fit for you. I’m excited to learn more about your journey and support you every step of the way! 💛Mersedes
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Nutrition Coaching Application

Basic Info

Goals & Habits

Which Option Best Fits you?

Commitment

Thank You For Applying