Are you ready to make positive change in your life?

Would you like to discover how amazing you can feel when you give your body and mind what it needs? Have you wanted to eat healthier for a long time, but didn't know where to start? Have you tried to maintain diets and other health regiments in the past, but they just wouldn't stick?

We're all busy. We get caught up in our hectic daily routines and for some reason the first thing that gets moved to the back burner is taking care of ourselves. It doesn't take long for this neglect to take its toll: stress, anxiety, feeling tired all the time, getting sick a lot, and sometimes even becoming a version of ourselves that other people don't really want to be around. It happens to the best of us, but it doesn't have to be that way! You can learn to create and take ownership of a more energetic and optimistic way of life. With a little help and guidance you can make strides to become your most vibrant and ideal self - and stay that way. It takes time and dedication, like anything in life that's worthwhile, but together we can make it happen!

Photo Credit: Jenna Perfette Photography LLC — Photo Credit: Jenna Perfette Photography LLC

What will you gain from working with ME?

Support and encouragement on your journey to health and well-being.
A safe space to confidentially express your health and wellness concerns and goals.
Time to explore your own aspirations and discover what is truly important to your personal growth and development.
Cultivate a new, healthy relationship with food.
Learn practical cooking techniques and become more comfortable in the kitchen.
Experience the chance to bring awareness to certain areas of your life that could use some attention and improvement.
Acquire skills that will allow you to take action and begin your life-changing transformation.
Gain self-confidence and develop stronger, smarter decision-making skills.
Encouragement to try new things and gain a new perspective.
Discover more reasons to be happy in your everyday life.

Tell me more about yourself and your Health & Wellness Goals

Consultation Form

Why you're completing this form:

In order for me to help you discover the root cause of your health and wellness concerns and formulate a personalized plan for sucess, I'll need to get to know you better. Our sessions will not only focus on healthy eating and exercise but also talking about things you've been through, what's going on in your life now, and where you see yourself in the future. When approaching healing from a holistic and integrative perspective, all aspects of your life are taken into account. It's all connected. It's bound to get personal. I take coach/client confidentuality very seriously (potential clients included). What happens and is discussed in free consultations and Health Coaching Sessions stays between us. Please be honest and get as specific as you feel comfortable. Click the box if you understand.

Ok, I get it.

First & Last Name

First Name

Last Name

Email Address

What are your main health concerns?

List aspects of your health and welness that you'd like to improve.

Numbers

Phone

What's the best number to reach you?

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Birth Date

YYYY

Age

How old are you (really, I won't tell anyone)?

Height

example: 5'7" = 5 7

Current Weight

ex. 185

Goal Weight

What's that "skinny jeans" number you're lookin' for?

Social Stuff

Occupation

What's paying the bills these days? How many hours are you working per week? What's your commute like?

Relationship Status

Are you single, married, divorced, somewhere in between?

Living Situation

Where do you live? House? Apartment? Do you live alone? Have roommates? A family? Any pets?

Health & Family Histories

How is/was the general health of your parents?

How's your DNA? Any history of chronic illness or cancer in your family?

How is your Sleep?

Tell me a little about how much and what quality of rest you get. How many hours nightly? It easy to fall and stay asleep? If you wake up during the night, what's the reason?

Any Serious ilnesses/hospitilizations/injuries?

Tell me briefly about any past health issues.

Any pain, stiffness, or swelling?

What ails you?

How would you describe your Digestion?

Do you experience bloating/constipation/gas/diarrhia regularly?

Do you have any allergies or food sensitivities?

Let me hear about it. Hay Fever to Lactose Intolerance. What makes you react and feel icky?

Ladies Only

Let's talk a little about your reproductive system.

Are your periods regular?

How long is your cycle? How many days is your flow? What are your symptoms and pain level like? Bad PMS?

Birth Control

What is the history of your contreceptive methods? How's it been going lately?

Do you have any children? Or are you planning to start a family?

Are you menopausal?

Please explain.

Have you experienced yeast infections or urinary tract infections?

If so, how frequently?

Health Regimens

Do you exercise or play any sports?

How do you stay active and keep your body moving on the regular?

Supplements and Medications

Please list any vitimans, supplements or other drugs you take on a regular basis and a short description of why you take them.

Do you see any healers, helpers, or therapists?

List any preventive health helpers with which you are (or have been) involved. Example: Accupuncture, Massage, Counseling, etc.

Eating Habits

Let's talk about food.

What was you diet like as a kid?

Did you have home-cooked meals a lot? Would you consider your diet "healthy"?

Do you cook at home?

How many days a week? What percentage of your diet is "real food" fresh, whole foods (not canned packaged or pre-made)? When you do cook, do you enjoy it?

Where does your food come from if it is NOT homemade?

Do you eat out? Order delivery? What restaurants/stores?

Describe what typical day of meals looks like for you?

Breakfast, lunch, dinner, snacks, and drinks. List what you eat and around what time of day.

Do you crave sugar, carbs, cigarettes, or have any major addictions?

Be honest. What do you feel you NEED? What are your vices? We all have them.

Going A Little Deeper

Give some extra thought to these...

At what point in your life did you feel best?

Be honest with yourself...when was the last time you were really feeling fantastic?

The most important thing I should do to improve my health is:

Anything else you'd like to share?

Do you have any questions for me?

What do you hope to gain from working with a Health Coach?

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Schedule A Free Wellness Consultation

Name

First Name

Last Name

Email Address

Please Pick 3 Dates and Times That you are available.

If you are within driving distance we can discuss meeting in person. If you aren't local, we can schedule a phone call, Skype, FaceTime, Zoom, or other virtual meeting.

1st Choice:

Date

YYYY

Time

Hour

Minute

Second

2nd Choice:

Date

YYYY

Time

Hour

Minute

Second

3rd Choice:

Date

YYYY

Time

Hour

Minute

Second

Courtney Shober Holistic Health

Integrative Health Coaching Services. Receive extra support and accountability around creating healthier, sustainable habits and working towards personal health & wellness goals and a thriving lifestyle.

Certified Integrative Health Coaching services for a happier and healthier life. Reading, PA and beyond.

Disclaimer: The views and nutritional advice expressed by Courtney Shober are not intended to be a substitute for conventional medical service. Entering into a Health program with Courtney Shober Holistic Health does not establish a doctor patient relationship. If you have or suspect that you have a medical problem, promptly contact your health care provider. We suggest that you continue to work with qualified medical professional as you engage in our Health and Wellness programs. No information offered here should be interpreted as a diagnosis of any disease, nor an attempt to treat or prevent or cure any disease or condition.

Work With Courtney

Are you ready to make positive change in your life?

Courtney Shober Holistic Health