Application Total Transforamation Coaching Experience

INTAKE & BOOKING FORMS

First Name *

Last Name *

Email *

Birthday

Home Phone *

Mobile Phone *

Skype Id *

Ideal Coaching Times *

City/Country *

1. Please list any/all diets you’ve previously tried. *

2. Please list any/all medications you’ve taken in the past *

3. Are you suffering from any illness, diseases or major health *

4. When did your weight problem begin (please be specific) *

5. Are you aware of any physical or emotional triggers that caused your weight problems to start? Explain… *

6. Did you gain your weight suddenly or gradually? Explain… *

7. Has your weight fluctuated frequently since your initial weight gain? Explain… *

8. Is your weight stable now? Or are you gaining/losing? Explain… *

9. How much weight do you need to lose? *

10. Are you currently dieting (meaning restricting intake, counting calories) *

11. Have you read, The Gabriel Method? If so, have you made any changes? *

I understand that Jon Gabriel and the Gabriel Method Coaches are not medical doctors, they are holistic health coaches. *

I understand that this program is not meant to diagnose, treat, or prevent any disease or illness. *

I understand that I am responsible for my own health at all times, and I am advised and expected to use any coaching in conjunction (not in lieu of) with professional medical advice. *

I understand that with any changes in lifestyle, there are certain risks involved, and I take full responsibility for my health and my choices. *

I understand that coaching is conducted by a team, and in many cases, coaches will share notes about my sessions with each other, but I can at any time request that they not share my notes with the other coaches. *

GM Support Group

Connect - Learn - Live The Gabriel Method

INTAKE & BOOKING FORMS