🌿 Start Your Wellness Journey 🌿

Thank you for being here. This short discovery form helps me get to know you a little better so we can make the most of our time together. There are no right or wrong answers — just your honest self, exactly as you are. Everything you share is held with care and confidentiality.

Let’s begin, gently and at your own pace. 💫

All information you share here is kept confidential and is solely used to create a supportive and personalized coaching experience.

First name

Last name

Email

Phone

What services are you most interested in?

Holistic Coaching (mind, body, and spirit)

Physical Wellness & Movement

Nutrition & Nourishment

Emotional & Mental Support

Self-Care & Lifestyle Routines

Not sure yet — I’d love your guidance

How often are you looking to meet for coaching sessions?

One session per week

Two sessions per week

Bi-weekly

Not sure yet — open to suggestions

What is your experience with movement or fitness?

I’m new to movement and fitness

I’ve worked out at home

I’ve worked out in a gym

I’ve practiced yoga

I enjoy outdoor activities (hiking, biking, etc.)

I’m currently active and looking for structure or support

Other

How would you describe your current energy levels?

How would you describe your relationship with food and nutrition?

I’m new to nutrition and want to learn

I have some knowledge but need support

I eat fairly well but want to fine-tune

I’ve struggled with food/nutrition in the past

Other

How would you describe your current stress levels?

Low — I generally feel calm and grounded

Moderate — I have occasional stress or overwhelm

High — I’m often anxious, overwhelmed, or under pressure

It varies day to day

Option I’m not sure / prefer to share during our session

Do you have any current health conditions, dietary restrictions or physical limitations you'd like me to be aware of?

What thoughts or beliefs most influence how you approach your goals right now?

On a scale of 1–10, how supported do you feel by your own mindset?

Is there anything from your background (spiritual, cultural, or personal values) that you’d like me to integrate or respect in our work together?

Do you have any current routines or rituals that support your wellbeing (morning practice, movement, journaling, spiritual practice, etc.)?

What does a typical day look like for you?

If you could imagine one shift this journey will bring you, what would it be?

🌿 Start Your Wellness Journey 🌿

Connect With Me