Application | Taylored Well Being

Please Fill Out The Application

First Name *

Last Name *

Email *

Phone *

Health Goals

Please share 3 specific health goals you are looking for support with regarding challenges related to your health. *

On a scale of 1-10: How committed are you to living a long and healthy life?

Be Honest- What is stopping you from having the health of your dreams? The more specific you are here the faster we'll get clarity while identifying the next steps needed to make progress. *

How is your current situation hurting your life? *

On a scale of 1-10, How coachable are you? In other words, are you ready, willing, and able to show up without cutting corners to do the work its takes in optimizing your health? * *

Have you ever worked with a practitioner/coach in a 1-1 setting or in a group setting? If so, who, what program, and in what capacity? *

Do you have a supportive spouse, significant other, or family/friend(s) who support you in reaching your physical, mental, and emotional health goals by understanding and aligning with your personal health mission? If so, who and in what capacity? *

What is maximum your willing to invest in feeling healthy, functioning optimally, and living longer? Please be honest! This is TOTAL. T

Do you have a Health Savings Account (HSA)? *

Which program are you most interested in? Please choose any of the ones that are of interest to you.

Online Course

Test Kit and Consultation WITH Follow Up's!

1-1 Coaching

Mentorship Program!

Do you have any questions about the personal journeys of the practitioners or about the practice? *

Yes

Why do you feel The Taylored WellBeing Community is the right place for you? *

Your information is secure. You can Opt Out at any time. By submitting this form, you agree to receive our emails and text Messages. Message & data rates may apply, Text STOP to cancel.

Our Step by Step Process:

Step 1:

After 5 Minutes Please Check you're email and look for our confirmation email.

Step 2:

Inside the email we have provided you all the things that we need to build your project. Please fill that out.

Step 3:

After you filled out the things we need please send it back to the email that we use.

Step 4:

After 24 hours one of our representative will contact you directly to confirm all the details.

Step 5:

Sit back and relax, we'll deliver the project to you within 7 to 10 days.