Application for 1:1 Wellness Transformation Coaching with Shae Leonard Wellness

First Name *

Last Name *

Email *

Phone *

Occupation *

Top 3 Health and Wellness goals you want to achieve *

Top 3 health issues you want addressed *

What have you tried so far that hasn't gotten you the results you want *

What are you most excited about in achieving relief and healing from your symptoms/concerns? *

Are you tired of wasting time and money on band-aid "fixes"? *

HEAL YES!

This program is a high-ticket investment in your health, ranging from $3,000 to $10,000, which includes personalized 1:1 coaching, visits, and labs. Are you ready and able to make this investment in your health at this time? *

Yes, I know this is a 10x better investment than more "band-aids"

No, I prefer not to invest in my health

Thank you for taking the time to complete this application. Your journey to health and empowerment is important to us, and we're excited to potentially work with you to achieve your wellness goals. We'll review your application carefully and reach out to you to discuss the next steps.