The Elite Woman Project Application

Apply to work with Dr. Sam PT, DPT

Are you a female founder, CEO, or entrepreneur? Work with me if you're looking to build your dream body the way you built your dream business/career.

Fill out the form below to apply—I can’t wait to get to know you and see if this program is the right fit for your next chapter.

When you click submit, you’ll be directed to my calendar to book your 45-minute Elite Woman Clarity Call.

On this call, you’ll speak directly with me, Dr. Sam. We’ll take a focused look at your current health and lifestyle, where things feel stuck, and what you want to change. We’ll talk through your goals, your daily reality, and the patterns that may be keeping you from seeing the results you want.

You’ll leave the call with clarity around what’s actually needed to move forward, along with a few immediate, practical steps you can start implementing right away to support your energy and wellness.

The purpose of this call is simple: to determine whether the Elite Woman Project is the right next step for you. If it’s a strong fit, we’ll walk through the enrollment details on the call so you can move forward with confidence and momentum.

Name

Phone Number

Have you worked with a coach before?

Yes

If yes, was it successful in reaching your goals for you?

If no, what made you decide it's time to reach out for help?

Now share your dreams & goals! Where do you want to be in 6 months? What would you like this program to help you with?

What have you struggled with most in attempting to achieve these goals in the past?

How committed are you to this 6 month transformation?

Fully committed 10/10!

Kinda - I'm not sure if I want to do this. 5/10

I don't want to do this. 0/10

Are you someone that is eager to make changes RIGHT NOW?

Why did you seek out this program over others?

When starting a new health and wellness program, what is most important to you?

A) A step-by-step plan with clear guidelines to follow.

B) Fast results and an exciting, high-energy approach.

C) A supportive community and personal connection with a coach.

D) Understanding the science and logic behind why it works.

What motivates you the most to stay committed to your wellness journey?

A) Having a structured routine and knowing exactly what to do.

B) Seeing progress quickly and feeling empowered by my results.

C) Feeling supported and encouraged by those around me.

D) Learning new information and understanding the deeper aspects of health.

This 6 month 1 on 1 coaching program is a financial & time investment. Please choose where you are financially & mentally in your ability to invest in a mentor to transform your body & mindset.

I have $500-$5,500 & 3-4 hours a week readily available and am ready to invest in myself so I can be guided hands-on in this process.

I don't have $500-$5,500 & 3-4 hours a week, but will get creative so I can get it & create time in my day (HSA card, corporate wellness expense, personal loan, supported by family/friends, delegating chores, etc.)

I don't have $500-$5,500 or 3-4 hours a week to invest in myself.

Apply to work with Dr. Sam PT, DPT

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