Lifestyle Coaching Lifestyle Coaching Name Name First Name First Name Last Name Last Name Date of Birth * Gender * MaleFemaleNon-BinaryPrefer Not to Say Email Phone Address * What are your main goals for lifestyle coaching? * Improve Energy Levels Reduce Stress & Anxiety Develop Healthy Eating Habits Improve Sleep Quality Enhance Fitness & Activity Levels Weight Management Other Other Sleep Less than 5 hours5-6 hours7-8 hoursMore than 8 hours Physical Activity SedentaryLight Exercise (1-2 days per week)Moderate Exercise (3-4 days per week)Active Lifestyle (5+ days per week) Stress Levels (Scale from 1-10) * Do you have any existing health conditions? * Are you currently taking any medications? * Preferred Coaching Format One-on-One Virtual Sessions In-Person Coaching Hybrid (Virtual + In-Person) Preferred Session Frequency Weekly SessionsBi-Weekly SessionsMonthly Sessions Preferred Coaching Focus Nutrition & Meal Planning Stress & Mindfulness Practices Sleep Improvement Fitness & Movement Work-Life Balance Package Selection Single Session Rs 20004-Week Coaching Package Rs 50008-Week Transformation Package Rs 8000 Payment Terms and Condition * I confirm that the information provided is accurate, and I agree to the terms of the Lifestyle Coaching Programme. Start Coaching If you are human, leave this field blank.
