Please be honest. This application is for people interested in my newest 1:1 coaching program where I teach busy people how to eat and workout however they desire WITHOUT sacrificing results. After you submit the form you will be taken to my scheduler page to schedule a time to chat.

Your Contact Information

First Name *

Last Name *

Email *

Phone (Please include area code) *

Your call preference

Gender

Male

Female

Your Age

Your Instagram Handle (Type "none" if you do not have one)

Body fat percent: (use the picture below to find what photo that most closely resembles yourself)

Your Current Employment

Job title and what it involves on a day to day basis

Discovery Questions

What is Your Goal? Please be specific. Goals do not need to be physical goals. (Ex: Lose 50lbs ...Tone up ...Get to 10% Bodyfat ...Be Healthy for my kids ...Overcome Anxiety/Depression)

What have you tried in the past?

Why didn't it work long term? What stopped you from achieving your goal AND/OR sustaining it? (Ex: Sustainability of the plan... Need Accountability... Don't Know What To Do... Plateaued Then Gave Up…)

On a scale of 1-10...1 being I'm satisfied where I am and 10 being I'll do anything to reach my goal, what number are you?

What would you expect from me as your coach if we decide to work together?

If selected, why will you be a good client to work with?

Does your spouse or significant other support you? (Meaning they will give you a thumbs up on whatever you decide)

Are you willing to invest financially to reach your goals? *

Yes

If accepted, how soon are you looking to get started?