Onboarding Form

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Name

Email

Phone Number

How did you find Living Wellthy?

What drew you to reach out for coaching right now? (What’s happening in your life that made you say, “Okay, it’s time”)

On a scale of 1–10, how happy are you with your current life overall?

What areas of your life feel the heaviest right now?

Weight / Body Image

Emotional Eating

Self-Worth / Confidence

Relationships

Healing from Past Trauma

Motivation / Purpose

Other

If Other, please tell us

What does “feeling stuck” look or feel like for you?

How do you usually cope when life feels overwhelming?

Have you worked with a therapist, coach, or support group before?

Yes

No

If yes, what worked or didn’t work for you?

What kind of support are you craving right now?

Accountability

Tools / Structure

Emotional Healing

Motivation / Mindset Shift

Just someone who gets it

What would “Living Wellthy” look like to you if you could design your dream life six months from now?

On a scale of 1–10, how ready are you to make real changes — even the uncomfortable ones?

1

2

3

4

5

6

7

8

9

10

What might get in your way (time, money, fear, self-sabotage, etc.)?

Time

Money

Self-sabotage

Other

If Other, please tell us:

What are you willing to do differently starting today?

If your life was a movie, what would this next chapter be called?

Finish this sentence: “I’m finally ready to stop ___ and start ___.”

Any other thoughts, questions, or things you want me to know before we begin?

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LIVING WELLTHY — FREE HEALING QUIZ

“Think you’re healing? Let’s find out for real.”

Everybody says they’re “working on themselves,” but half the time they’re just reading quotes on TikTok and calling it growth.

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→ What stage of healing you’re actually in
→ Why you keep repeating emotional patterns
→ How ready you are for real change
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You’ll get a personalized email from me based on your score with the next steps.

Take the Free Healing Quiz