Wellness Right Now

First name*

Last name*

Email*

Confirm email*

How did you hear about Wellness Right Now? (referral, IG, etc.)*

I'd love to hear about your primary goals in us working together! How does your dream body feel?*

What have you tried in the past to reach these goals? SELECT ALL THAT APPLY.*

Low calorie diets

Macro tracking

Cutting out foods or food groups

Weight loss programs (i.e., beachbody, weight watchers, jenny craig, herbalife, Optavia, etc.)

Tons of cardio

Weight-lifting

Cleanses and detoxes

Please enter your Instagram Handle*

This will be used to start or continue our conversation in the DMs!

Please enter your contact phone number*

This will be used for booking a call together if needed.

Please check all boxes below to confirm the following:*

I am over the age of 20.

I am not currently suffering from an eating disorder or have experienced this in the past 5 years.

I realize that by submitting this application, I am consenting to have Coach Leanna of the Wellness RN reach out to me if needed via Instagram, Phone or Email to discuss what a coaching relationship would look like.

It is out of my scope of practice to coach/diagnose/treat cleints with an eating disorder - if you have questions or concerns, please reach out to me directly at wellnessrn.ofnc@gmail.com

If we both decide working together is a good fit, the investment is a 3-figure investment! Are you prepared to make this investment if it means reaching all the goals you've shared?*

Yes, I'm ready to pay in FULL!!!

Yes, I'll need a payment plan

No, my goals can wait

Nutrition Coaching