Name
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First Name
Last Name
Email
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Where do you live?
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Describe where you are now in terms of your diet, health and lifestyle. What does "here" look like? Please describe your current diet. Do you have any health challenges, diseases, medical issues past or present? What kind of lifestyle are you currently leading?
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Has a medical professional ever told you that you need to change your diet?
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Describe to the best of your ability where you want to be regarding your diet, health and lifestyle. What does "there" look like? What are your diet, health and lifestyle goals?
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What are the hurdles you will have to overcome to get from A to B? Who or what is getting in your way? Include all self-sabotaging behaviors, beliefs, habits, etc
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What resources do you have to draw on that will enable you to transition from A to B? Include all the wonderful things you have going for you!
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How will you know when you've arrived? What will be different about your life? How will YOU be different?
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What would happen if you made no changes in your diet, health and lifestyle, and things stayed more or less as they are?
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What level of support are you hoping to get from Emily? Please choose the ONE statement that best matches your current circumstances.
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I'm all in! I'm committed to changing my diet and lifestyle, and will allocate the resources to make it happen.
Not sure. I definitely want to change my diet, but have a few questions first.
I don't have the time or energy to take action right now. I want someone who can do it all for me.
DONE! Thank you for applying!
I look forward to reading your application. I typically review applications within 1-2 business days. If I think you would be a good fit for my coaching program, I will send you a link to schedule a Clarity Call.
Please know that I carefully review every application that I receive, and if there are any quick helpful suggestions that come to mind I’m happy to send them your way.
Wishing you great health!
XO Emily
