Nutrition to Soar n=1:1 Coaching Application Form

This is an application form for determining suitability for 1:1 Nutrition to Soar Coaching. The questions are designed to ensure we are perfectly suited as client and practitioner/coach so you can expect a superior results-driven service from our specialised skillset and experience working with evidence-informed nutrition and exercise science principles as it relates to the female over 40. It also ensures commitment and readiness to change on your behalf to ensure you are coachable to guarantee your successful outcome. Please response as honestly and with as much details as you can. 

Click the button below to start.


Question 1 of 17

Please provide your full name, and best contact email and phone number. 

Question 2 of 17

Which Country and City do you reside?

Question 3 of 17

What is your date of birth and current age?

Question 4 of 17

Please choose which stage of hormonal transition you are in. 


Pre-menopausal, normal menstrual cycle


Pre-menopausal, abnormal menstrual cycle


Perimenopausal (with or without symptoms or menstrual cycle irregularity)


Postmenopausal (>12 months since your last period or surgically induced menopause)

Question 5 of 17

Describe your health and fitness journey up until now including any diets you've tried (please let me know if you have a diagnosed eating disorder or history of one and your activity background).

Question 6 of 17

Why do you want to work with me?

Question 7 of 17

What is your main challenge when it comes to your health, managing the midlife transition, performance and body composition?

Question 8 of 17

Tell me about your menstrual cycle. Do you have >9 cycles per year? What is the average length of you cycle? Do you struggle with your period, if so, in what way? Are you on any form of contraceptive? If so, please name specific type and brand. 

Question 9 of 17

How has your nutrition behaviours impacted other aspects of your life? What is the impact of continuing your current behaviours going to mean for you in the future if you don't change?

Question 10 of 17

What are 3 characteristics you NEED to embody to accomplish to improve your health, performance or body composition? (If it helps, you can base this off a mentor or someone you aspire to be like who is where you wish you were) 

Question 11 of 17

If you started to act from a place of those characteristics right now, what do you think would be the outcome?

Question 12 of 17

We don't get to midlife without unravelling a few layers that have kept you small, so if we get real and honest right now, what has prevented you from achieving the results are after? The more specific you are the faster I can decide if you are a good fit for Nutrition to Soar n=1:1 coaching. 

Question 13 of 17

How ready and committed are you to start working on your goals/health right now? Choose a number from 1-5.


1 have no intention of changing my behaviours right now to achieve my goals or get results.








5 I am BUSTING to start actioning things NOW, let's do it!

Question 14 of 17

Do you have the resources and time to invest in your health, performance or body composition now?




I am not in the position right now to invest in myself fully



Question 15 of 17

If accepted into Nutrition to Soar n=1:1 Coaching, will you let me hold you accountable to your highest self and mirror your limiting behaviours or negative subconscious thinking patterns if necessary (including on our application call?)




I am not ready to face my limitations with an open mind just yet



Question 16 of 17

Take a moment to collectively add up all the money to date you have spent on diets, supplements, vitamins/minerals, books, seminars, webinars, magazines, courses, challenges, gym memberships, equipment (e.g. ab rockers, lighter bike frame or specific running shoes etc). Is it in the vicinity of;














So much I can't even fathom to add up

Question 17 of 17

Can you afford to invest  approximately $400/month on your optimal mid-life health, mood, perimenopause symptoms, performance and body composition (knowing that Nutrition to Soar n=1:1 is a 12 month coaching time frame and the last "diet" you will ever need)?


Yes I am in a position to invest in my health and wellbeing with an expert in perimenopause nutrition


No I am not financially in a position to invest in myself and my optimal mid-life transition yet

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