We Are Better Together!
I'm so glad you are here! My name is Laura Kleber and I have a love for health and wellness and guiding others to do the same. I help match people with a complete plan that includes personalized coaching, a support community, education and a nutrition-oriented mindset. Please answer a few quick questions so that I can determine next steps in order to help you become the healthiest version of you!
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Before you begin...
By filling out this form, you are expressing interest in having a conversation. I am not here to judge, but to help. Please be as open and honest as possible with your responses. This will be a no pressure call but will give you the information needed to make an informed decision. Once you submit this form, I will reach out using the information provided below to set up a time to talk. Please be prepared to respond when I do. Thank you, in advance, for reaching out. Taking this step was brave and, sometimes, the hardest step to take. So congratulations on that!
Tell Me More About You
These quick questions help me understand what brings you here and whether this metabolic reset may be a strong fit for you.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Time Zone
*
Are you reaching out for yourself or someone else?
Please Select
Myself
Someone else
Both!
Where did you hear about me?
*
Please Select
Facebook
Instagram
Friend
Family Member
If friend or family member, please share their name
First & Last Name
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Have you taken the Metabolic Dysfunction Quiz yet?
*
Please Select
Yes
No
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What do you think is your biggest challenge?
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Your Answer
What Are Your Current Symptoms?
Which of these describe you right now?
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Fatigue or low energy
Difficulty losing weight
Poor digestion or bloating
Mood swings or irritability
Sleep Problems
Sugar Cravings
Brain fog or difficulty focusing
Slow metabolism
Hormonal imbalances
Frequent hunger or overeating
Other
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On a scale 1-10, how out of sync does your metabolism feel?
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Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
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What have you tried so far to fix resolve these symptoms?
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Diet Changes
Exercise Routines
Supplements
Detox Programs
Medication
Therapies or coaching
Fad diets
None
Other
Why do you think those things have not worked long term?
Your Answer
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How are these symptoms / challenges affecting your life right now?
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Reduced Energy and Motivation
Impact on Family Relationships
Work Productivity Decline
Mood /Mental Health Challenges
Physical Discomfort or Pain
Social Withdrawal
Financial Stress
Low Confidence
Other
If nothing changes in the next 6-12 months, what do you think could happen?
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Let's talk about what results you are hoping for?
What matters most to you right now?
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Improved energy and vitality
Weight loss and body composition
Mental clarity and focus
Better sleep quality
Emotional balance
Long-term health and longevity
Hormonal balance
Other
What support do you feel you need the most?
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Accountability coaching
Simple nutrition made easy
Exercise Guidance
Mindset and Motivation Support
Stress Management Techniques
Community Support
Other
What current habits or patterns are holding you back the most?
Your Answer
Are you ready for a True Metabolic Reset?
If there was a proven path that burns fat, protects 98% of your lean mass, and reverses metabolic dysfunction, how open are you to following it exactly as designed?
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Very open and committed
Somewhat open, need more info
Not sure yet
Not open at all
Are you prepared to invest time, energy, and money into your health if the plan fits you & your budget?
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Yes
Yes but would like more details
I am not ready to make changes and feel better
If accepted, how soon would you want to start?
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Right away
This week
Within the next 2 weeks
Other
Are we Facebook friends? If not, please send a friend request to Laura Kleber (link below) so you can see daily encouragement, healthy recipes, and get inspiration/motivation. In case Facebook does not allow you to send me a friend request, under what name can I find you on Facebook?
*
https://www.facebook.com/laura.kleber.3
16 Week Metabolic Reset Results
Is there anything else you would like me to know before I review your application?
Your Answer
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