Consulting Application Book your consultation call 1 Step 1 Choose your coachLeslie Hooper (one-time $149 consultation fee)Steph Miramontes (one-time $99 consultation fee)Laura Kalirai (one-time $99 consultation fee) Calendar First Name Last Name Emailemail Age (applicants must be 18 or older) Phone number Skype username In general, what is your goal? Please list the concerns you have about your health, eating habits, fitness and/or body.0 / Out of all of the above concerns, what sounds the most important/urgent? Why?0 / Right now, on a scale of 1-10, how consistent are you with your current eating habits?1 being inconsistent, 10 being very consistent. If you’re less consistent than you’d like, what seems to be the obstacle? Do you feel like you have trouble controlling your appetite/hunger?YesNo Do you struggle with food cravings?YesNo Do you have a history of binge eating?YesNo Have you ever noticed a connection between your emotions and eating habits?0 / If yes, what happens?(e.g. When I have a work deadline, I get stressed and nose-dive into a pint of Ben & Jerry’s Chunky Monkey)0 / How often do you think about food and eating (or avoid eating)?Select an optionAlmost alwaysOftenSometimesRarelyNever If you feel you’ve eaten too much, what do you do afterwards?Select an optionTry to eat less at subsequent mealsSkip the following mealsTry to exercise it offFeel guilt/shameTry to get back in control of thingsPurge (vomiting/laxatives)Forget about it and go back to normal eatingKeep eating. What the hell, I’ve already blown it! Thinking about everything you’ve responded to here, what do you think you might start to like working on or addressing first?0 / What do you expect from me as a Coach?0 / How much is your dream body worth? What are you willing to invest to achieve this goal? Price ItemTotalConsultation Fee1[field51]Annual Charge $xxx Total: $[field51] Book Your Consultation Call keyboard_arrow_leftPrevious Nextkeyboard_arrow_right FormCraft - WordPress form builder
