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Fill out the application below

1:1 Emotional Eating Coaching Application

Hey there! I'm excited you're here and ready to take the first step toward emotional eating freedom. This is huge! So, all you have to do now is read through the application, fill in your answers to the best of your ability, and I will be getting in touch within 24 hours! Let's get started!

P.S. Your answers are confidential and for my review only!

Full Name *

Email *

Phone *

How long have you been struggling with food, your weight and/or your body image? *

How would you describe your problem? *

If I could wave a magic wand, how would you like your life to look in 12 months time? *

Have you sought help with this before? *

If you answered 'Yes', can you tell me what type of help, for how long, and if you felt it helped or not? *

On a scale of 1-10, how motivated are you now to truly tackle and overcome this issue? *

What would it mean to you to overcome your struggle with food, emotional eating and body image and move on with your life, free of all the stress associated with this issue? *

WORK WITH ME

Fill out the application below

1:1 Emotional Eating Coaching Application

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