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State
Do you have PCOS or think you have it? <Select one>
I have been diagnosed with PCOS
I think I have PCOS
I'm here for something else
What symptoms are bothering you the most currently?
What changes would you like to see to your health in the next 6 months?
What have been your biggest obstacles to attaining your health goals?
So far in your journey, what have you tried to improve your symptoms? What worked and what didn't?
Do you understand I operate as a concierge practice? (No insurance billing, high-touch care model) <Select one>
Yes
No, I'd like to learn more
When it comes to making your health a priority, what level of investment feels aligned for you? <Select one>
$350-$1000
$1000-$4000
$4000-$6000
$6000-$10,000
$10,000+
Is there anyone else (spouse, partner, parent) that will be involved in the decision-making process? If so, will they be attending the call? <Select one>
No
Yes, but will not be on the call
Yes, and will be on the call
How soon are you looking to start working with me? <Select one>
Right away
Within the next month
1-3 months
Not sure, just exploring options right now
What is your main reason for seeking a health coach? <Select one>
More personalized attention
Access to longer appointments
Holistic care and support
Convenience and flexibility
How committed are you to making lifestyle changes to reach your health goals? <Select one>
100% committed, willing to do whatever it takes
Somewhat committed, but need support
Looking for guidance, but not sure if I can fully commit yet
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