AESTHETIC LIFE
My name is Kelly Harding and I am an Online Nutrition and Fitness Coach. I personally have lost over 60 pounds through diet and exercise, and I just finished training for my first Body Building Competition and placed 2nd in very tough division of nearly 30 competitors. I have diligently worked on my Nutrition, mindset and fitness and this has become my passion. Now, I guide others on their journey to better health with nutrition and fitness with one-on-one personal coaching. My support ranges from helping people that need to lose 0 pounds and wanting to build muscles, to helping people lose over 100+ pounds. I will help you have a healthier relationship with food and become aesthetic, not only in your physical looks, but your overall wellbeing. Aesthetic Life is designed around becoming the best version of yourself physically and mentally.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contacts
*
Phone Call
Phone Message
Email
Age
*
Ex:23
Gender
*
Please Select
Male
Female
N/A
Medical
Do you have any health conditions?
*
Yes
No
Please describe
*
Sleep
How many hours do you sleep?
*
Less than 5 hours
5 - 6 hours
7 - 8 hours
9 - 10 hours
More than 10 hours
Hydration
In a day, how much water do you drink usually?
*
In a day, how much coffee/caffeine do you drink usually?
*
In a week, how much alcohol do you consume usually?
*
Movement
Do you do any exercise?
*
1 - 3 a week
3 - 5 a week
Everyday
Never
What kind of exercise do you participate in?
*
Eating Habits
How many meals per day do you eat?
How often do you eat out in a week?
*
Always
Usually
Sometimes
Rarely
Never
Other
Have you tried to lose weight before?
*
Yes
No
What have you found to be the most difficult part of losing weight in the past?
*
What is your main goal/concern at this time? (What are you looking for with one-on-one training with me?)
*
Thank You! Kelly will contact you within 24 hours!
Print Form
Save
Submit Survey
Should be Empty: