Coaching Questionnaire

Congratulations!

You're one step closer to optimizing your energy, performance and results to feel more

focused, confident and energized.

Answer this short questionnaire to

qualify for the next step.

To confirm, you are filling this out because you want to optimize your energy, performance and results + make this the LAST COACH you’ll ever need? *

Yes - I am serious, and want to learn how to take a data-centered plan.

No - I’m going to leave this page immediately.

Full Name *

Phone *

Please confirm your mobile number [It's really important this is correct so that we can confirm your application + help you book your free strategy session]

Instagram Handle *

Email *

Allows our team to share free resources with you.

Blood Work, Biomarkers & Health Awareness

Have you had blood work done in the last 12 months? *

Yes

No

Has a doctor or practitioner ever reviewed your blood work with you in detail? *

Yes, Thoroughly

Yes, but it was quick / confusing

Not at All

I have not had blood work in the last 12 months

Do you understand your biomarker values and what they mean for your health and performance? *

Yes, Very Well

Somewhat

Not at All

What did you find out from our blood work, if anything? *

If no blood work, please type N/A

Have you ever attempted hormone therapy, peptide therapy, or other optimization protocols?

Yes, currently

Yes, in the past

No, but curious

No, not interested

If yes, what worked well and what didn't? *

If no, please type N/A

What has been the biggest obstacles keeping you from reaching your performance goals so far? *Choose as many as you like

What would a “WIN” look like for you in the next 90 days? *

Why is NOW the right time to address this? *

Which of the below best describes your goal? *

I want to lose between 10-25lbs of stubborn fat, regain the energy, and focus I once had, and feel in control of my results

I want to restore my hormones and understand why my past attempts at “diets” have failed.

I want to lose some weight and feel more confident in my skin + regain a healthy relationship with food.

I’m not exactly sure what my specific goals are, but I do know my approach to nutrition, fitness, and health is not working the way I would like them to.

What makes you interested in working with our team specifically? *

Because I want to utilize a proven method that will address the underlying root causes of my energy and weight loss issues, instead of being told “eat less, and move more.”

The support, knowledge, and accountability of your team allows me to fully trust that a data-centered approach is best suited to get results.

All of the above

I’m not very familiar with your program, but I am interested in learning more!

Do you have a significant other? If so, are they supportive of you potentially investing in your weight loss, health, and personal growth? *

Yes, I have a significant other and they are supportive.

Yes, I have a significant other but this is my decision to make.

Yes, I have a significant other but they may need to be on the call with me to make a joint decision.

No, I’m single and make my own rules, lol

Last question: If we were to find a way to optimize your health, and learn how to keep your results for LIFE, making this the last coach you'll ever need - would you be willing (and able) to invest in getting the help necessary to get there? *

Yes, I have the cash flow to invest in myself.

Yes, I may or may not have the cash flow but I'm resourceful and/or have access to credit.

No, my cash flow is month to month and I have no access to credit.

We'll Review And Be In Touch For Next Steps.