Join My Weight Loss Program Today!

Watch this 3-min video to learn more

I'm so glad you’re here! Below are a few questions for you to answer so I can see if we will be a good fit. I'll be reaching out to you soon!

Name

First Name

Last Name

Phone

(###)

###

####

Zip Code

Birthdate

YYYY

Social Media Handle or Name

How did you hear about me? (please list name or social media handle if referred by someone)

What prompted you to reach out to me for help?

What are your biggest challenges or obstacles with your nutrition?

Are you currently using an app to track your food?

If not, are you open to using one?

On a scale of 1 to 10, how committed are you to making changes with your nutrition?

1 = not at all, 10 = very committed

Are you looking for an overly structured/strict meal plan, or does something a bit more flexible sound appealing to you?

At this time, are you willing to make a premium investment in your nutrition goals and a coaching program?

Do you have any reservations about joining a nutrition coaching program? If so, please list them here!

Is there anyone else involved in the decision-making process that needs to be involved?

If we decide we are a good fit to work together, will you be ready to start in the next 30-60 days?