BMT Blueprint Application Form - BMT Coaching

Name: *
Email: *
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Thanks so much for your interest in working with me in the BMT Blueprint weight loss program!  Please answer the below questions so that I can learn a bit more about you. 

I am a coach who not only works with you to achieve your weight loss goals, but also focuses on helping you develop strategies for lifetime weight maintenance and how to eat so you can feel your best.  Are you EXCITED about this?

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What is your height?

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What is your current weight?

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Have you been diagnosed with any of the following conditions?

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How many total medications do you take (including prescription medications, non-prescription/over-the-counter medications, vitamins, and supplements)?

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What would you like to weigh 6 months from now?

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What is the biggest challenge keeping you from reaching your weight loss goal?

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What have you been trying so far to help you reach your goal?

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Tell me about your current eating habits. What do you usually eat for breakfast, lunch, dinner, and snacks?  Any food allergies or sensitivities?

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What do you think will happen to your health and/or life if you continue doing the same thing that you are doing now and don’t make any changes?

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If someone advised you to work with a coach to help you implement a system to get you to your weight loss goal and give you everything you need to maintain your weight loss for life, would you jump at the opportunity to put that system in place?

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When it comes to investing in your health, who is involved in the decision-making process? 

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The BMT Blueprint is a 6 month program.  When paid in full upfront, the investment is $5574.  If paying in monthly installments, the investment is $999 per month for 6 months.  Are you ready to make such an investment? 

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Thanks for taking the time to answer these questions!  I'll reach out to you via email and/or text message within 2 business days so we can talk about your next best step to permanent weight loss transformation. I can't wait to connect with you!