Coaching Questionnaire

Let's see if this is a good fit!

This application is for individuals with autoimmune or chronic conditions who are serious about improving their health, fitness, or physique in a sustainable, long-term way.

My coaching is structured, highly individualized, and designed for lasting results. This is not a quick fix and it is not for everyone.

If that sounds like what you're looking for, go ahead and continue. The application takes about 5 minutes to complete.

I review every application personally and will be in touch within 48 hours.

To confirm — you have an autoimmune or chronic condition and you’re looking for structured 1:1 coaching to improve your health, fitness, or physique in a safe and sustainable way that supports your long-term health. *

Yes - that's me

Yes, but I’m still exploring whether coaching is right for me

I'm just browsing

Full Name *

Which of the following best describes your primary goal right now? *

Lose body fat in a way that supports my health

Build muscle and strength

Improve physical capacity, resilience, and overall quality of life

A mix of the above

In 6 months, what would make you look back and say "this was 100% worth it"? *

What's happening right now that made you realize something needs to change? *

What have you already tried when it comes to fitness or managing your health? *

When it comes to staying consistent with your health and fitness, what has gotten in your way in the past, or what do you think might get in your way now? *

Please list the condition(s) that you've been diagnosed with. *

How would you describe your current health status? *

In remission or mildly active disease - symptoms are generally manageable

Moderately active disease - I function but symptoms do affect my daily life

Unstable or severely active disease - recently hospitalized, or my symptoms severely limit my ability to function

What symptoms affect you the most, and what does a bad day or week typically look like for you? *

Are you under the care of a medical provider for your condition(s)? *

Yes

If requested, are you willing to obtain written medical clearance before starting? *

Yes

Are you currently in need of physical therapy, hands-on rehabilitation, or supervised medical care to exercise safely? *

I am working with a provider but cleared for independent training

Yes, I require hands-on rehab or supervised medical care

What made you reach out to me specifically? *

This is a highly personalized 1:1 coaching program built for people with autoimmune and chronic conditions. It's a 6-month commitment with direct, ongoing support. I keep my client roster intentionally small to maintain a high standard of coaching. If we’re a great fit, are you ready to make the financial investment listed on the website? *

Yes, I'm ready to commit if this feels right.

I'm considering it, but not ready to commit yet.

No, not at this time.

Email *

Phone *

AK Health & Fitness