Apply for 1:1 Root-Cause Coaching to Finally Fix Bloating, Fatigue & Weight Gain

Share a few details about your health, lifestyle, and goals so we can see if you’re a fit and, if so, come to your call with a personalized game plan to reduce bloating, rebuild your energy, and lose weight without giving up your culture’s food or derailing your career.

Section 1: About You

First Name *

Last Name *

Email *

Phone *

Instagram *

Age *

Occupation (what you’d put on LinkedIn or a business card) *

Do you have a significant other, and if so, how do they feel about you investing in your health, weight loss, and personal growth? *

Yes, I have a significant other, and they’re 100% supportive of me taking this step.

Yes, I have a significant other, but this decision is mine to make.

Yes, I have a significant other, and they’ll likely need to be part of the decision.

No, I’m single and I make my own decisions.

If you’re a SAHM or unemployed grad/PhD student, do you have a partner or parent who could financially support you in investing in your health/fitness if this is a good fit? *

Yes

No

N/A – I’m employed and able to make my own financial decisions

Section 2: Your Health & Goals

Your answers here help us understand whether root‑cause testing and coaching is appropriate for you and what type of protocol we’d recommend.

What are your current health challenges? (check all that apply) *

Section 3: Readiness & Investment

Coaching with us is a meaningful financial investment. These questions help us understand what options make sense for you.

On a scale of 1–5, how committed are you to taking action on your health in the next 30 days? *

This program is not free. It’s a meaningful financial investment. If we create a plan you feel confident will help you reach your goals, which best describes you right now?

I have the financial resources, I’m ready to do what it takes, and I’m SO ready to reach my goals.

My budget is tight, but if this is exactly what I need, I’m open to figuring out payment options to make it work.

I’m not willing or able to invest in my goals at this time.

This is confidential and only used to see if you may qualify for third‑party payment plans.

If we’re a good fit, when would you ideally like to begin working together? *

Immediately (this week)

Within the next 30 days

1–3 months from now

Just gathering info for the future

Section 4: Final Details

How did you find us / who referred you? *