TTCE Intake Form | Gabriel Method

Total Transformation Coaching Experience Intake Form

Name*
First Last
Email*
Birthday
MM slash DD slash YYYY
Phone*
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. *

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