Radiant Health Mastery Application Form

Radiant Health Mastery Application Form

A 4-month private functional health coaching program for high-performance women battling with chronic symptoms like fatigue, weight gain, IBS, hormonal imbalance, or inflammation—despite “normal” lab results. Includes advanced functional lab testing, bi-weekly 1:1 strategy calls, personalized healing protocols, and between-session access for ongoing support. This is a high-accountability, data-driven container designed to help you uncover root causes and reclaim full-body energy, clarity, and confidence. Once your application is reviewed, Leslie will reach out personally if you’re a good fit for this level of support.
Name*

First NameLast Name
Phone Number*

Country CodeArea CodePhone Number
Email*
How did you hear about LJW?*
If your application is accepted, the next step will be to join a brief call with me so I can provide recommendations on which of my services best suits your goals. Do you prefer Zoom or Phone Call?*

Zoom callPhone call
What are the top 2-3 symptoms or struggles you're currently dealing with?*

FatigueBloating or digestive issuesWeight gainBrain FogCystic Acne or Skin IssuesIrregular or Painful PeriodsMood swings, anxiety, or low motivationSleep Issues
How long have these symptoms been going on?*

Less than 3 months3-12 monthsOver a yearFeels like forever
What have you already tried that hasn't worked? *
How would your life change if you were to heal these symptoms? *
Why now? What's motivating you to take action at this point in your life? *
How ready are you to invest in expert support to get to the root of your health struggles and finally feel good in your body?*

Just curiousI'm in the process of scoping potential expertsI'm ready and serious
Which best describes you?*

I'm ready to invest now if it's the right fitI'd love to, but I need help with payment optionsI'm not in a place to invest right now
Is there anything else you'd like me to know about your health history or goals? *
Should be Empty: