Application to Work with Carole
This application helps me determine if you’re a strong fit for this level of coaching since I work very closely with my clients. If you are a match, I'll invite you to schedule a 1:1 private Zoom call with me so I can learn more about your journey and goals. Please fill out the following information and I will get back to you within 48 hours with the next steps.
Name
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First Name
Last Name
Email
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example@example.com
Gender
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Please Select
Male
Female
Other
Date of Birth
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Please select a month
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Please select a year
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Year
Height
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Current Weight
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Goal Weight
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What are your health goals?
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What are your current obstacles to success on your own?
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I know what to do, but I struggle to stay consistent
I turn to food when I’m stressed, overwhelmed, or emotionally drained
I feel out of control around certain foods, even when I try to avoid them
I struggle to prioritize myself and follow through on healthy habits
I do really well for a while, but then something happens and I go back to my old habits
It's hard to stick to healthy habits because my friends and/or family aren't supportive
Other
Are you currently being treated for any health issues? Please list below.
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Which of these are important to you in selecting who to work with to achieve your health goals?
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A highly-trained expert that can help me breakthrough where (and when) I'm stuck.
Personalized guidance (not one-sized fits all)
A clear, proven system, process, and/or program
Support, accountability, and motivation to help me actually follow through
A coach who challenges my thinking and helps me see blind spots
Someone who understands (and knows how to heal) the deeper patterns behind my eating habits (not just what to eat)
A sustainable approach I can maintain long-term (not another quick fix)
Feeling understood, supported, and not judged
Other
How did you hear about me?
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How much are you willing and able to invest to achieve your health goals?
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Very little; I want cheap or free options.
$300ish per month
My health is invaluable and I'm ready to invest whatever it takes.
How soon are you looking to get started?
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Yesterday! I want to feel better now.
Within a few days or up to a week.
A few weeks or months.
Unsure; just researching options right now.
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