PHC Application | The Health Coach Group

Health Coaches

Fields marked with an asterisk (*) are required. All fields except for your street address will be shown in the public directory. By completing the form, you will be added to our AWeber Health Coaches mailing list (expect a confirmation email) and our Health Coaches Directory listing.

Name*
PayPal Email for Payment*
Photo
Accepted file types: jpg, jpeg, png, gif.
Bio*
Provide a brief biography or story of your experience as a health coach.
Email*
Website (must include http:// or https://)
Phone (US)
Phone (International)
Address*
Your City, State/Province and Country will be shown in the directory.

Street Address City State / Province / Region ZIP / Postal Code Country
Primary Specialization*
Secondary Specialization
Third Specialization
Coaching Credentials
Education Credentials
Hourly Rate for Billable Time
Hourly rate in US $. Enter as a whole number or decimal with no dollar sign.
Your Ideal Client
Reliability*
Tell us about your availability and why we could count on you to be reliable and on time for appointments. Is there anything that could get in the way of your work with THCG coaching clients?