Private Coaching Application

The application helps me get to know you better and ensure I’m the right fit to support your needs and goals.
Once reviewed, I'll email you to coordinate a 30 minute initial call to finalize details and answer questions.

First name

Last name

Phone

How did you hear of me?

what are your primary health concerns or symptoms (e.g., gut issues, acne, inflammation)?

Do you have any diagnosed conditions (e.g., IBS, IBD, thyroid issues)?

Have you undergone any recent medical tests or treatments for your gut or other health issues?

How often do you experience digestive discomfort (bloating, constipation, diarrhea)?

Have you noticed any patterns or triggers for your gut issues (specific foods, stress, etc.)?

Do you take any supplements or probiotics for gut health? If so, which ones?

Have you ever worked with a nutritionist, dietitian, or health coach before? If yes, what was that experience like?

Describe your typical daily meals (breakfast, lunch, dinner, snacks)

Do you currently or have you followed any specific diet (e.g., gluten-free, vegan, low-FODMAP, etc.)?

How many vegetables/fruits do you consume a day? (best estimate - be honest, no judgement)

How often do you consume ultra-processed foods (e.g., packaged, bagged, premade, fried, vegetable oils)

What do you think are your biggest challenges are around nutrition/food?

Do you have any known food intolerances, allergies, sensitivities? or ones that you suspect but aren't sure?

How often do you exercise, and what type of activities do you engage in?

How many hours of sleep do you get each night, and is it restful?

Describe your stress levels and the sources of stress in your life.

What does a typical day/routine look like for you (work, family, personal time)?

Do you engage in stress-management techniques like meditation, yoga, or other relaxation activities?

Do you smoke, drink alcohol, or consume caffeine? If so, how often/how many years?

What steps have you taken so far to try to improve your gut health/ health concerns?

What challenges or obstacles do you anticipate facing when it comes to making changes in your nutrition, lifestyle, and mindset? (e.g., peer influence, emotional eating, time, money, etc.)

What are your wellness goals (e.g., weight loss, improved energy, better digestion)?

A year from now, if you were able to achieve your wellness/health goals, how would life look different? How would you carry yourself? What would change in your day-to-day life?

What excites you when you think about a life without your gut/health problems?

How much of a financial investment are you willing to make in your health to achieve these results?

$0-50

$100-250

$500-1000

$1500-2500+

You can be honest, no judgement :)

Which coaching program are you interested in?

Nourish & Flourish - 6 week program

The Next Level You - 4 Month Program

I'm not sure yet

Please provide several days and time slots you could be available for a 30 minute video chat with Britt.

Yes, I want to subscribe to Her Gut Newsletter for gut care tips, offers, & feel-good support.

Private Coaching Application

The application helps me get to know you better and ensure I’m the right fit to support your needs and goals. Once reviewed, I'll email you to coordinate a 30 minute initial call to finalize details and answer questions.

The application helps me get to know you better and ensure I’m the right fit to support your needs and goals.
Once reviewed, I'll email you to coordinate a 30 minute initial call to finalize details and answer questions.