Work with Me Application - Private – Tracy Campoli Coaching| Pilates, Weight Loss Coaching, Fitness

Application to Work With Me

Please answer all questions as thoroughly as possible.

All applications are reviewed personally by me. Applications are sorted according to order received, and those that are most qualified will get noticed first.

You will receive a reply within 48 hours to schedule our one on one conversation to discuss your specific needs and determine the next best action step for you.

First Name*
Last Name*
Email*
Phone Number (or Skype if outside the US)*
What caused you to be ready to work with me now?*
What is the single biggest challenge you are facing right now? Why is it so important for you to solve it now?*
What is your #1 Goal that is MOST important to you right now?*
What has stopped you from achieving this goal? What is your pattern and or your reasons or excuses? (we ALL have reasons and excuses, so don’t feel bad, you’re human! This is an opportunity to shine some light on what has kept you stuck)*
What is struggling with your body and your health costing you in your life? Be specific about how it's affecting your relationships, confidence, money, career, etc.*
What have you tried in the past to improve your health? Have you worked with a health coach or done a health coaching program before?*
What is your urgency for solving this on a scale of 1-10? (10 is high - YES, I'm ready to get the support I need and do what it takes right now, 1 is low - I've got too many things to do, everything else comes first and this always falls last)*
What attracted you to me and my coaching program?*
How did you learn about me?*
Do you feel you are in a position to comfortably invest in your health and self development now?*
How are you currently investing in your health and wellness? (for example: massages, personal trainer, accupuncture, classes etc…)*
Age*
Weight*
Location*
Marital Status*
Occupation*
Income Bracket*