LRNH Client Application
Are you ready to take control of you health & nutrition? Let's go!
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Age
-
Month
-
Day
Year
Date
Sex
Male
Female
Height (ex: 5'4")
Weight (lbs)
Goals
Weightloss
Lose Fat
Maintain Weight & Eat Better
Muscle Building
Better Lifestyle choices
What are your wellness goals for the next 3-6 months? Why are these goals important to you? Be very specific, the more detail the better!
Current workout routine & nutrition (food types, # of meals per day cardio, lifting....and how many days/minutes per week...honesty please)?
Do you have any injuries (past and present) or surgeries/health conditions to note (i.e. PCOS, gastric bypass, hysterectomy, hypothyroidism, HRT, IBS, etc.)
What past diets have you done? When was your last diet?
Have you counted macros or calories before? If so, how many calories are you eating right now?
Why do you want to work with me?
What is your biggest hurdle in getting to your goals AND why do you want to make a change now?
High level coaching requires an investment that starts at a few hundred dollars per month and I want us to be YES to work together - financially, physically and emotionally. Are you ready to invest in yourself? Be sure to book a call afterwards to talk options!
Yes, let's go!
I'm nervous but interested in learning more
Not at the moment
No
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