Your Bariatric Journey

Surgery date:

Current Stage:

Where did you have your surgery?

Current Challenges

Tell us more about your main challenge:

Your Goals

What are you hoping to achieve through coaching?

What does success look like for you 3 months from now?

Support & Lifestyle

Have you worked with a bariatric coach before?

If yes, what worked? What didn't?

What's your work/life situation?

Do you have any physical limitations that affect movement/exercise?

If yes please explain:

Program Interest

Which option are you most interested in? (Check all that apply)

BariBestie 24/7 support

Success Club - 5 sessions/week, app access, group chat, Facebook group, personal coach, Foundations Course

1:1 Coaching - Private 45-60 min sessions

Barinourish Meal Plans - Customized meal plans for your stage and needs

Not sure yet - want to discuss options

What's most important to you in a coaching program?

Additional Information

Is there anything else you'd like the team to know before your consultation?

How did you hear about us?

Next Steps

Once you submit this form, Maree will review your information before your consultation. This allows her to:

Understand your unique situation
Prepare personalized recommendations
Make the most of your time together
Answer your specific questions

We're looking forward to supporting you on your journey!

Your information is confidential and will only be used to provide you with the best possible support and coaching recommendations.

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.

By checking this box, I consent to receive marketing and promotional messages, including special offers, discounts, new product updates among others. Message frequency may vary. Message & Data rates may apply. Reply HELP for help or STOP to opt-out.