Are you ready to take back control over your health?

Fill out the application form below to apply for the Resilient Mama Method. We can’t wait to hear from you!

First name

Last name

Phone

Date of Birth

What are your main health conerns?

What would IDEAL success with your health look like to you?

What has been the biggest obstacle in hitting your health goals?

Why is it important that you solve this health challenge right now?

Tell us about your nutrition! What do you usually eat for breakfast? Lunch? Dinner? Snacks? Drinks?

Tell us about your workout routine over the last 6 months

Have you had any serious illness, hospitalization or injury?

What excites you most about working with Amy Slater Coaching? Be as detailed as possible :)

How much have you invested in your health so far? What was the result?

Do you have the financial resources to invest in your health right now?

Yes, I have the financial resources to invest in my health (typical program costs are $4-$6k, payment plans available)

No, not at this time, but I am willing to be resourceful and find the funds to invest in my health

Anything else we should know?

Thanks for filling out this form! We will review your application and get back to you within 3 business days.