Application
Thank you for considering me to help you with your health and fitness goals! The purpose of this application is to offer me a good understanding of where you’re at and what you need to help you become the BEST you.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Age
Height
Weight
Goal Weight (if applicable)
Occupation
(This helps me determine your daily activity level.)
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As far as health and fitness goals, what exactly are yours? What are you trying to do or achieve?
Why is right NOW the best time in your life to work on these goals and what exactly led you to reach out to me?
Aside from weight (if applicable), what other goals do you have in regards to your health, wellness, and overall well-being?
How long have you had these goals or desires? Have you ever done anything before to make these changes, and if so, what did you try and for how long?
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On a scale of 1-5, how important is achieving your goals, starting right now, to you?
Not important
1
2
3
4
Extremely important
5
1 is Not important, 5 is Extremely important
Which of these best describes you?
I am ready to invest in myself financially and emotionally for a healthier future, body, and lifestyle.
When push comes to shove, I will find a way to find the time and finances to invest in a healthier future, body, and lifestyle.
I do not have the time, energy, or finances to make a healthier future, body, and lifestyle a priority for me right now.
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