What best describes your biggest goal right now?
*
Lose 20-50 lbs
Lose 50+ lbs
Preserve/build muscle while losing fat
Improve my blood work & overall health
I want all of the above
Are you currently taking a GLP-1 medication?
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Yes
No, but I’m considering it
No
How long have you been trying to lose weight?
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Less than 6 months
6 months-2 years
2-5 years
More than 5 years
What’s your biggest obstacle? (Choose one.)
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Staying consistent
Nutrition
Lack of accountability
Busy schedule
Low energy
Emotional eating
I don’t know what actually works
Do you have recent blood work available?
*
Yes
No
Not sure
Are you ready to invest in coaching if we’re a good fit?
*
Yes
Possibly—I want to learn more first
* Not at this time
Why do you want to change your life now?
*
If we build the right plan together, how committed are you to following it?
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10/10 — I’ll do whatever it takes
8-9/10 — Very committed
5-7/10 — Somewhat committed
Under 5/10
Full Name
*
Age
*
Height
*
Weight
*
Goal weight
*
Biggest struggle
*
Taking a GLP-1?
*
Blood work available?
*
Phone
*
Email
*
Why do you want coaching?
*