Your health journey- the first steps

Exploring Your Health Journey

with Baker Health
First Name*
Last Name*
Email*
example@example.com
Phone Number*
Format: (000) 000-0000.
Preferred Method Of Initial Contact

TextCallEmailFb MessengerIg Messenger
What are your current struggles when it comes to your health and wellness?*

0/330
What are your goals when it comes to your health and wellness?*

0/330
Have you worked with a health coach before?

YesNo
What are you looking for in a health coach at this time?*

0/330
Are you currently purchasing any supplements or products to support your current health goals? If so, what are they?*

0/330
On average, how many times a week are you eating out? (Please include your number of meals, gas station or coffee shop stops.)

On a scale of 1-5, 5 being all in, what is your level of motivation to make a change?

	1	2	3	4	5

1 is None at all, 5 is All in

Exploring Your Health Journey