Please Complete This Application
If we don't get an application from you, your booking WILL BE CANCELED. Please BE HONEST.
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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-
Area Code
Phone Number
Instagram Handle
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How long have you known me for?
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Less than 6 months
More than 6 months but less than a year
Over a year
Occupation
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Age & Weight
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Do you feel like you need help?
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Yes
No
Not sure
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What is your goal exactly with your physique? ? Lose 20 lbs? Gain lean muscle mass? Tone? Overcome negative thoughts about your physique? Be specific. Doesn't just have to be a physical goal!
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What is MOST important for you to learn from me?
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What have you tried in the past and why hasn't it worked for you? What usually stops you from hitting your goal?
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On a scale of 1-10... 1 being I'm satisfied where I am and 10 being I'll do anything to reach my goal. What number are you?
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Do you have a support group that will Does your spouse or significant other support you? (Meaning they will give you a thumbs up on whatever you decide)
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Yes
No
Not applicable
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What would you expect from me as your coach if we decide to work together?
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Space is very limited and I want to make sure this is a good fit, why do you think you would benefit from a call or be a good addition to our mentorship, if invited?
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With that being said, are you willing to invest in YOURSELF to reach your goals?
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If accepted how soon are you looking to get started? (if you aren't ready please just wait and schedule when you can. I expect those who feel it's a fit to move forward. Those who don't take actions are 95% more likely to continue to do nothing).
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I realize I'm booking a real time slot with you.
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Yes
No
I will be available to take the call in a quiet, distraction free environment at our agreed upon time.
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Yes
No
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