Name
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First Name
Last Name
Email
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Phone
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Where do you live (state/country)? What is your time zone?
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How did you find me? Is there a person, website or event that referred you?
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What issues and/or symptoms are you experiencing that you need help with from health coach or are you looking for a life coach and what do need help with?
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What have you tried in the past that worked?
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What have you tried in the past that didn't work?
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Describe ideal health and ideal results that you want to accomplish if we work together?
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What do you feel has stopped you from getting to the ideal health and happiness and results you're hoping for?
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What is solving this problem worth to you?
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How do these issues affect your day to day activities, social life, relationships, or your mental/emotional state?
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Are you willing to change your diet and make your own meals for 4-6 weeks as part of your healing process?
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Which one describes you best?
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If during the conversation you feel that my approach and healing program is what you've been looking for, how soon can you start?
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Please let me know if you have any other questions or concerns. Thank you for your time and commitment to your health!
