BMT Breakthrough Application Form - BMT Coaching

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Thanks so much for your interest in working with me in the BMT Breakthrough weight loss program!  Please read the description of the program and then answer the below questions so that I can learn a bit more about you to make sure that it is a good fit for you. 

Here's how the Breakthrough will unfold over the course of 6 months:

  • First, we’ll create your powerful transformation statement for weight loss so that when the journey starts feeling hard (because it will), you have something to look at to remind you of your “why”.  We’ll also work on your pre-lapse protection plan so that you know how to share your intentions with your family and friends and how to get the support that you need.
  • Then, we’ll walk through the 4 major nutrition game changers (water intake, quality of food, quantity of food, and sodium intake), ONE at a time, so that you have SIMPLE steps to start supercharging your weight loss while knocking down the mental roadblocks that can have you feeling stuck, overwhelmed, and doubtful that weight loss is doable and possible for you.
  • Next, we’ll put on our detective hats and investigate your current eating habits and lifestyle so that we can make custom shifts to your nutrition that still fit into the lifestyle that you want to have.  We’ll check for gaps in your meal planning and nutrition and review how to fill those gaps so that you can meet your goals.
  • Then, we’ll fine-tune your roadmap for success (with meal planning at home and on the go, snacking, food cravings, stress eating, sleep, hormones, body shape, and all the other factors that affect weight loss) so that you know what and how to eat to keep making progress when you’ve had a bad day at work, when life throws you curveballs,  at holiday celebrations, at family gatherings, when you’re out with friends, when you’re sad, when sugar is calling your name, when you want to give up, and when you’re not getting support from your circle.  You’ll learn how to stay consistent and how to indulge without getting derailed.
  • Finally, we’ll celebrate your weight loss victories (scale and non-scale) and create your relapse prevention plan so that you never have to “diet” again.  You’ll have everything you need for LIFETIME success.


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 have you been trying so far to help you reach your goal? What has worked? What hasn’t worked?

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

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Why do you need to overcome this challenge right now?

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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 Breakthrough is a 6 month program.  When paid in full upfront, the investment is $2844.  If paying in monthly installments, the investment is $499 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!