Group Coaching Application

Once you complete an application, you'll be invited to book a call with one of our practitioners. This will allow us to learn more about you and ensure the programme is a perfect fit. You’ll also have an opportunity to ask any questions you may have.

Telephone / Email / Whatsapp text / Whatsapp video / Text message*

If no, please specify how you would prefer for us to communicate with you:

Are you happy to speak to our practitioner via Zoom so that she can learn a bit more about you and answer any questions you have? (Yes / No)*

What makes you most excited about joining the group?*

Are you ready to invest in your programme? (Yes/No)*

Are you ready to start your journey to making peace with food today? (Yes/No)*

Is there anything you would like to share about your journey so far?*

I want to feel happier in my body | I want to stop binge eating | I want to understand nutrition | I want to stop yo-yo dieting | I want to stop emotional eating | I want to find peace with food*

Which of the following are important to your recovery:

Please tell us a little about what you would like to achieve through this programme?*

Email Address*

Phone Number*


Full Name*

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