AliveHealthTX
Home
Zone Technique
Nutrition & Supplement Shoppe
The Healing Zone
Contact Me
Home
Zone Technique
Nutrition & Supplement Shoppe
The Healing Zone
Contact Me
Facebook
Instagram
8 week program
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Email
*
Email
Confirm Email
Phone
*
What specific physical or emotional health goals would you like to achieve through this coaching program?
*
of you a
On a scale of 1-10, how committed are you to improving your physical/emotional health, and changing your life?
*
0
1
2
3
4
5
6
7
8
9
10
Please explain your rating.
*
What types of support have you previously sought for any health-related concern?
*
What current physical or emotional health challenges do you feel are holding you back from achieving your goals?
*
What strengths or coping mechanisms do you possess that you can leverage to enhance your overall health?
*
How do you typically manage stress in your daily life?
*
Are you open to exploring new strategies or practices for emotional regulation and physical well-being? Please elaborate.
*
Do you have a vision for how you want your life to look personally, professionally, and financially?
*
Are you willing to devote daily time and energy to activities focused on improving your mind, body and thoughts?
*
What self-care practices do you currently have in place that support optimal health? What brings you joy?
*
How well do you handle change, in any area?
*
Are there specific areas related to your physical or emotional health (e.g., fitness, nutrition, emotional health, balance) that you want to focus on during this coaching program?
*
What are your current thoughts and feelings around food, and how do they affect your eating habits?
*
How do you currently approach movement and physical activity in your daily life?
*
What fears or roadblocks do you have that have kept you from achieving your goals in any area of your life?
*
Have you tried to implement daily habits, but were not able to sustain them for any length of time? (examples: exercise, eating well, drinking water, maintaining a consistent bedtime)
*
What physical activities or forms of exercise do you enjoy, or want to explore further?
*
Are you willing to be held accountable for making changes that support your health during this program?
*
How do you define your current support system, as it relates to pursuing a healthy lifestyle? (spouse, friends, family, healthcare professionals)?
*
Is there anything else you would like us to know about your personal health, history, lifestyle, or experiences before we begin?
*
Thank you for taking the time to answer these questions. I will review, and respond within 24 hours with our next steps. Blessings, Tracy
Submit