Thank you so much for showing interest in my service (Jordan’s Nutrition & Fitness Coaching) and more importantly taking the next step to invest in yourself! I can not wait to learn more about you!

Please fill this application out to help me better understand what you specifically need to take your health and fitness to the next level!

Full Name *

Email *

Phone *

How old are you? *

What is your Instagram Handle/FB?

What are your main nutrition, fitness, and health goals? *

How would reaching these main goals change your life? *

What creates the biggest challenge to achieving your overall nutrition, fitness, and health goals? *

What is your occupation and how many hours do you work on average? *

On A Scale Of 1-10, Rate The Stress You Accumulate From Your Job (1=Everything's Good, 10 =Stressed To The Max All The Time). *

On a scale of 1-10, exactly how READY, WILLING, and ABLE are you to achieve your goals? (1 besting not ready, nope, not going to do it! 10 being IMMMMM REEEADDDYYY!!!!) *

If you were referred, who should we thank?

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

Does your spouse or significant other support you emotionally and financially? (Meaning they will give you the thumbs up should you want to move forward with this investment in your health.) *

Yes

N/A

Starting a health journey is a commitment physically, emotionally, spiritually, and financially. Which of the following best describes your personal finances? (Please answer truthfully, as this is a huge part of determining the advice we give you.)

Why are you interested in Jordan's Nutrition & Fitness Coaching? We are selective with the clients we bring into our program. *

Is there anything else I should know?

By providing my phone number I agree to receive text messages from Jordan's Nutrition & Fitness Coaching.