Apply For The Glowing Woman Program Now!

* Please Note that spots are reserved for those who are highly interested and motivated to heal. By applying, you are under absolutely no obligation to join. If I think you'd be a good fit, you'll receive an invite with the next steps you need to take!

First Name *

Last Name *

Date of birth *

Email *

Instagram Handle

What state do you live in? (U.S based Clients only) Do not accept Rhode Island, Kansas, or New York Clients due to labs unable to ship there *

How did you hear about me? If a specific person directly referred you, please state their first and last name.

What are your main health concerns? *

What are your current goals? Check all that apply *

Improve anxiety, mood, depression, mood swings

Work on digestive issues (bloating, constipation, loose stool, gas)

Balance hormones

Improve brain fog & clarity

Increase energy

Other

We view labs as essential in truly helping us get to the root cause of how to optimize your body and get you feeling your best. Are you wanting to have comprehensive functional medicine lab testing completed for in depth data? *

Definitely

Maybe

Absolutely Not

Tell me about the most important goal you’d like to accomplish in the next 3-6 months: What do you want to change about your body, your health, your mindset and your lifestyle? *

If you were able to reach these goals in the next 3-6 months, how would you feel? How would your life and happiness be different?

Why do you think you haven’t been successful in the past in reaching these goals? *

Why do you want to work with Alexis? *

Coaching is an investment into your body, your health & yourself - are you ready to make that financial investment? *

YES

I'm not sure

Not at this time