1:1 Nutrition Coaching Application
With Joelle Renwick
Name
*
First Name
Last Name
Email
*
example@example.com
Instagram Handle
Have you ever worked with a nutrition coach before?
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Yes
No
What is your age, sex, and current activity level (sedentary, lightly active, active, or extremely active)?
*
Do you have experience with macronutrient tracking?
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Yes
No
Have you ever been diagnosed with an eating disorder?
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Yes
No
No, but have struggles with my relationship with food and disordered behaviour/thinking
Coaching with me requires you to be responsible to do your assigned check-ins, be open minded, communicate openly (no ghosting), and follow through with the commitments you make to me and yourself. Are you confident you will be able to follow through with these requirements?
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Yes
No
Oftentimes, the support of those closest to us can make or break our goals. Is your spouse, family, or friends onboard and supportive of your decision to do nutrition coaching?
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Yes
I haven't told anyone yet
No, but I can make my own decisions.
Not applicable.
What is your current primary goal?
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Fat loss
Learn more about nutrition
Weight maintenance/gain
Other
What are your short and long term goals with nutrition and/or body?
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Getting honest, why do you think you have not already reached those goals?
*
Are you financially stable and able to invest $200-$250 per month on coaching?
*
Yes
No
Thank you for taking the time to fill out this application!
1:1 coaching is a high support experience that requires commitment, dedication, and a willingness to learn. I’ll be in touch within 48 hours.
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