Michelle Carroll Coaching

Coaching Application Form

First name*

Last name*

Email*

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Are you currently undergoing treatment for a clinical eating disorder? Or have you ever been treated for a clinical eating disorder?*

Clinical eating disorders require treatment from appropriate healthcare professionals. I may not be able to work with you. Please send me an email michellecarrollpt@gmail.com and we can chat further.

What is your reason for wanting to work with me?*

e.g. improved body image, relationship with food, improving sporting performance

What do you struggle with the most when it comes to food?*

e.g. overeating, knowing when to eat, making healthy choices

Is there anything else you think I should know?*

e.g. medical conditions, fears/concerns about working with me

Can you commit to at least 3 months of coaching to improve your health and body image?*

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