Apply to Coach With Michelle
Please fill out this form and I will personally get it. Then you will be able to choose a time on my calendar so we can meet and see if we are a good fit to work together!
What sort of relationship do you have with food currently?
What is the exact reason(s) you have NOT achieved your food, exercise and/or body goals so far?
What exactly would you like to achieve through eliminating emotional eating? (Meaning - What do you want your life to look like?)
Exactly how is your weight affecting other areas of your life?
How long have you been working on emotional eating, weight, etc. (including time spent researching, trying things, exc)?
How much have you invested in losing weight in the past 90 days? (Including supplements, food programs, fitness memberships, etc).
If you are in a relationship, would you describe your partner as:
Supportive and encouraging
Not unsupportive, but not entirely interested either
Unsupportive and discouraging
What is your employment status:
Stay at home mom
Facebook Profile ID
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How Did You Find Us?
Search Engine (Google, Yahoo, etc)
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