Fit Mom Balanced Life Questionnaire
Let us capture your vision and values so we can help you create the body of your dreams! 

My next group starts SOON so please fill out the form below! I will get back to you within 24 hours on the weekdays, 72 hours over the weekends.

I know sharing some of the info on this form can make you feel a little vulnerable, but I can promise you that your answers will be confidential - it's just to help me help you better. 

After losing 40 pounds after my first baby and then another 30 after my second, I can WITHOUT A DOUBT say that having a coach like me and an accountability group is the best thing you can possibly do for yourself! I've been there. I know what it takes and I am still on this journey WITH you, every step of the way! You will also have support from other like-minded women in our private tracker app.

My coaching is 100% complimentary! Your only investment is the complete home workout program and nutrition package that is best for you. My goal is helping you achieve sustainable results and making lifestyle changes, so it's important that I get to know your needs, goals and struggles, which is what this form will help me do! So please take it seriously! 

Fill out the form below and I'll get back to you in the next 24-72 hours, letting you know if you have been selected. I truly wish I could work with everyone, but I have to make sure I limit the amount of new clients I take on, so my clients get the best support  and results! I hope you understand!

Again, please take this form seriously and don't rush through it! I won't be picking participants based on speed, I will be picking based on the info you provide! I want to work with those who are ready for change and I need to know your needs, goals and struggles, to decide if what I offer is the best fit for you. I can't wait to chat with you! Let's get better together!

*This group is NOT for those already happily working with another coach or currently a coach themselves. US and Canada residents ONLY!
What is your name? *

What is your name as it appears on Facebook and what is your email address? *

What is your age range? *

Check all that apply. *

Choose as many as you like.

How would you rate your current nutrition? 5 meaning you watch your portions and eat clean.

Energy is everything. Tell me how you feel? *

What are your health and fitness goals? Having a vision and measurable goals is SO POWERFUL ~ That is where success is made? *

Check any of the following that apply. *

Choose as many as you like.

WHAT or WHO really motivates you to live a healthy and fit lifestyle? And, what is your reason for change? *

who do you admire? Who do you follow? Who do you look to for inspiration? WHAT inspires you? It could be a friend, public, figure, your kids...anything.
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