Private Coaching Form - Anna Cortesi

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WHAT YOU Get

"Private Coaching aims to inspire you through your journey of self-love and self-discovery, help you to listen to your body, eat wholesome meals and stop depriving yourself of your favourite food"

Hello there!

Please take a few moments to complete these questions, for me to learn a little bit about you, your life and your aspirations. This will help me understand how my programs would be of benefit to you.

PLEASE NOTE:

* Any details shared will stay private and confidential. I urge you to provide as much information as possible as this will help me understand your personal story and ultimate wants and needs.

If you had the ability to change anything about yourself...

General Concerns and Frustrations

How important is it for you to feel physically comfortable in your body?

Not important at all Not very important Very important

How important is it for you to fix and balance your current relationship with food?

Not important at all Not very important Very important

How important is it for you to improve your body image?

Not important at all Not very important Very important

How important is your career to you?

Not important at all Not very important Very important

How committed are you in investing your time and money in your health and personal development?

Not committed at all Quite committed Very committed

I acknowledge that by filling out this application form, I am under no obligation to join Anna’s Coaching Programs, but I am ready to invest in this private, lifestyle nutrition coaching program. I understand that in case of my acceptance into one of these programs, I am committed to completing the program within its duration.

Do you understand the statement above? If so, please check yes.

Please accept the following in order to submit your request:

I hereby consent to the processing of my personal data in accordance with the Privacy Policy

I have read and accept the Terms and Conditions

Thank you for taking the time to apply! A member of the team will be in touch with you soon. Best of health and balance,