Coaching Application/Contact Info

Hello! If you are interested in working together, please fill out the following form. Within 24-48 hours you will be contacted to schedule your consultation.

Coaching Application

First Name

Age

Height

Last Name

Phone

Weight

Social Handle

What are your health and fitness goals?

What do you want to change about your body, health, your mindset, and/or lifestyle?

What have you tried to achieve your goal? What has worked? What has not?

What's your biggest challenge in reaching your goal?

If you were able to reach these goals in the next 3-6 months, how would you feel? How would your life and happiness be different?

Give me a rundown of your current exercise routine and diet.

Are you currently tracking your food intake (calories and/or macros)? Have you ever tracked your food intake before?

Coaching is an investment into yourself - On a scale 1 (Nevermind, I am not ready) to 10 (I'm freaking ready for help) where are you?

Why did you choose me?

Thank you! I will be in touch.

Contact

Phone

717-309-4933

cultivate.nb.you@gmail.com

Social Media