ALL IN by Teddi - Accountability Coaching with Teddi Mellencamp

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Accountability Coaching

Welcome! For those interested in our Accountability Coaching Program, please honestly fill out the form below and take the first step toward achieving your goals. All form fields are required. Thank you!

Your Name

Your Email

What is your location (city & state)?

Your current weight?

Your goal weight?

Your height?

Your age?

Your gender?

Describe your current workout regimen? Be specific.

What are your current eating habits like?

Please tell us about any past or current medical conditions, injuries, limitations, or other that we should be aware of?

Have you or do you suffer from any eating disorders? If yes, please list disorder(s) and the dates the disorder was active.

Are you currently taking any medications? If yes, please list medication(s) and the condition it is prescribed for.

What other programs have you tried in the past?

What is your personality type?

What is your Instagram handle (if you have one)?

Please upload a current full-body photo of yourself.

Click to Read & Agree to the Terms of Service

Please note that completing this screening process enables us to review your application for ALL IN By Teddi™. Providing this information does not guarantee acceptance. ALL IN By Teddi™ reserves the right to determine to determine eligibility to participate. Please note that all photographs or other images submitted will be treated confidentially and will not be used, disclosed, or shared in any way other than by ALL IN By Teddi™, our coaches, and you.

Check to agree to each of the following before submitting:

I understand and acknowledge that ALL IN By Teddi™ is an approach to health and weight loss-focused wellness and fitness for people in good health, and not a medical, nutrition, or diet program, and that its Accountability Coaches are not licensed health professionals and have no healthcare training. I understand that Accountability Coaches focus only on eating and weight loss and maintenance goal, not other personal issues.

I agree to seek the clearance of a physician or qualified medical professional to manage my health and determine if ALL IN By Teddi™ and its components are appropriate for me. I understand that I should not apply for ALL IN By Teddi™ if I have a medical condition that would limit my ability to restrict my eating or to exercise vigorously on a daily basis.

I understand that my success participating in ALL IN By Teddi™ depends upon my commitment. I am ready, willing, and able to devote the time needed to complete and fulfill the Program. I agree to responsive and cooperate in meeting the ongoing requirements of participation in ALL IN By Teddi™ in a timely manner.

I understand that I should not apply for ALL IN By Teddi™ if I know or suspect that I may be pregnant, have an eating disorder or related mental or behavioral health problem requiring management under the care of health professional, diabetes, or any other unmanaged physical, psychological, or emotional condition involving purging, binging, or other activity that would present any risk form vigorous exercise or diet.

I understand that ALL IN By Teddi™ reserves the right to require a medical clearance letter as a condition of participation. I understand that ALL IN By Teddi™ takes no responsibility for managing my health and is not serving as my doctor, dietician, or other health professional role.