Coaching Application Form

PCOS and Nutrition ( is not a licensed dietician or nutrition specialist.  By submitting this application, you state that in consideration of your participation in PCOS and Nutrition's coaching services and any information you obtained from PCOS and Nutrition, you for yourself,  your personal representatives, administrators, heirs and assigns, hereby holds harmless, PCOS and Nutrition from any claims arising from your participation in the coaching program. In addition, by filling out and submitting this application, you affirm that you have read, have been honest with PCOS and Nutrition and also fully understand and agree to the information provided in the Terms & Conditions.




Please recognise that fact that it is your responsibility to work directly with your physician before, during, and after seeking fitness consultation. As such, any information provided is not to be followed without the prior approval of your physician. If you choose to use this information without the prior consent of your physician, you are agreeing to accept full responsibility for your decision.


Coaching Questionnaire