Why are you reaching out to a Health Coach? What specific health, wellness, and lifestyle changes would you like to make?
On a scale 1-10, how important is it to you to make each one of these changes?
1-Not Very important 10- non-negotiable
On a scale of 1-5 please rate whether you agree or disagree with the following statements:
1= Strongly disagree 3= Unsure 5= Strongly Agree
I am open-minded about learning new ways of eating, moving, and living
I can commit to changes that feel uncomfortable, unusual, or unconventional
I will communicate and negotiate with my health coach as an equal partnership, and feel confident to ask for what I need
I will keep my word to my coach and myself
I understand health coaching is an investment in myself for positive long-term change
Thanks for submitting!