Ready to Work Together?

Please fill out this application below and I'll reach out shortly to schedule our initial call. Thank you

Application Form

Full Name

Phone

Instagram Handle

I engage in / need help with:

stress eating

emotional eating

normal eating

balanced eating

portion control

how to quit dieting

skipping meals

food guilt

I don't know what to do if not dieting

binge eating

What does your dream life look like in regards to your eating habits?

How would living your dream life impact your daily life? ie friends, family, mental health, relationships, confidence, self esteem etc

The goal of this program is help you stop thinking about food, stop second guessing yourself and help you feel confident in your food choices. This is not a weight loss program.

I understand

Due to the intensive nature of my program, this is both an investment of your time and resources. How ready are you to make changes right now?

very ready

somewhat ready

not ready

On a scale of 1 to 10, how motivated are you to reVIVE your life and mindset? 1 being not motivated and 10 being very motivated.

Thank you for your application! I'll be in touch soon.

Contact Me

First Name

Last Name

What are you looking for?

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Phone

519 562 0467

Address

Tecumseh ON

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