Apply for Private Longevity Coaching

Apply for Private Longevity Coaching

Thank you for your interest in Private Longevity Coaching.

This six-month coaching partnership is designed for active adults who want a personalized, integrated strategy for their training, nutrition, recovery, and long-term health.

Your responses will help me understand your goals, current challenges, and whether this experience is the right fit. Please answer thoughtfully and openly.
Basic Information
Name

First NameLast Name
Email
example@example.com
Where are you currently located?
What is your age range?
Your Goals
What prompted you to seek support at this time?
What would you most like to improve over the next six months?
What activities, abilities, or experiences are most important for you to preserve over the next five to ten years?
Current Challenges
What are you currently doing to support your health and fitness?
What feels most difficult or uncertain right now? Examples include knowing how to train, nutrition, recovery, consistency, travel, physical limitations, conflicting advice, or understanding what to prioritize.
Coaching Fit
Which areas would you most like support with? Select all that apply.

Other
Private Longevity Coaching is a six-month engagement with an investment of $6,000, payable in full or in six monthly payments of $1,000. If we determine that the coaching is a strong fit, are you prepared to make this investment?
Is there anything else you’d like me to know before reviewing your application?
Where did you hear about me?

Other
Should be Empty:

Basic Information

Your Goals

Current Challenges

Coaching Fit