Name *

First Name

Last Name

Phone *

(###)

###

####

Do you prefer virtual or in person? *

In person

Virtual

Either

What time of day works best for you? *

Mornings

Afternoons

I'm flexible

When it comes to making changes, which description best fits you?

I am good at being patient, consistent, and taking small steps.

I know long-term success comes from small habits built over time, but I struggle to be patient.

I need a quick fix.

With guidance, I am willing to work hard and be patient.

Yes

No