Full Name *

Email *

Phone *

What are you struggling with health wise? *

What are your main goals with your body right now and what do you want me to help you with specifically? *

On a scale of 1-10, how happy are you with the current state of your body & health? What have you done to improve it? *

Are you coachable and willing to apply my coaching methods consistently? *

YES

No

Are you willing to financially invest in your coaching to fix these things? *

YES

NO

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