Private Coaching Application - Behind the Binge

1:1 Private Coaching Application

Behind the Binge Team, here! We are so glad you’re seeking support. In our private coaching, we guide people who have spent years in diet culture, the restrict/binge cycle, and food obsession move towards a life filled with physical, emotional, and mental freedom around food and their bodies.

Our work is weight inclusive meaning, success is not determined by the number on the scale. Our practice is grounded in Intuitive Eating and Health at Every Size®. Anyone working with us/hired by MaKai Nutrition is proficient in these methodologies and are trusted by us to provide you the best care. You can specify in this application if you have a preference of who you’d like to work with. We are currently hiring another practitioner and their information and bio will be listed on my website as soon as they are onboarded.

Name*
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Briefly describe your biggest problem with food/eating.*
How would you describe your body image?*
On a scale of 1 to 5, how ready are you to change your behaviors around food?*
- 1, not ready
- 2
- 3
- 4
- 5, 100% committed to making changes
Private coaching is an investment of $175 per initial session (60-75 minutes) and $165 per follow up session. Are you in a place to make that financial commitment at this time?*
- Yes
- No
Please note that we require an one month commitment (4 sessions). We do not accept health insurance.
If you marked no, what financial investment could you make at this time?*

There are other options we may provide for you if we see fit.
I understand this is NOT a weight loss program*
- Yes, I understand
Consent*
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