Full Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Instagram Handle
*
We would love to follow along on your journey!.
STATE/COUNTRY:
*
Your Time Zone:
*
List typical availability to setup Consultation Call (24-72 hours):
*
Current Age:
*
Current Height:
*
Current Weight
*
Referral Source(s):
If no referral, We’d love to know how you’ve heard about Rize Fitness.
Have you ever worked with an Online Coach/Trainer ?:
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Never
Yes, within last 6-8 months.
Yes, but it has been longer than a year.
No, but I am ready to take on the discipline & accountability!
Which Service are you Inquiring about:
Online Coaching and Nutrition.
In Person Training
Hybrid approach (1x/week in person +Online Coaching)
Nutrition Plan (monthly Subscription includes weekly check ins)
A one time Exercise Program ( very tailored to client’s goals)
Current Goal(s) you’d like to accomplish with us:
*
Fat Loss (body Recomp)
Building Muscle
Focus on internal Health (Gut/Digestion/autoimmune etc)
Future bodybuilding Bikini/wellness competitor
Understanding & learning Nutritional Habits
Just want to get Healthy and Feel Better
Do you prefer a specific Coach (1st Pick):
*
Please Select
Coach Brook
Coach Caylee
Whichever coach that fits me best.
In short answer, what is your main goal with personal training| coaching?
*
*if you've had a coach before- please briefly explain what you liked and disliked during your duration with them*
CURRENT LIFESTYLE/PROTOCOL:
LIST ANY CURRENT SUPPLEMENTATION| ALLERGIES:
INCLUDE EXACT PEDS/DOSAGES, MEDICATIONS, VITAMINS, GENERAL SUPPLEMENTS*
CURRENT ACTIVITY LEVEL(CONSIDER YOUR CAREER/LIFESTYLE):
*
VERY LITTLE MOVEMENT, DAILY
I WORKOUT 2-3X/WEEK
IM FAIRLY ACTIVE 4-6X/WEEK
I CURRENTLY ONLY DO CARDIO
I TRAIN/LIFT 7X/WEEK + CARDIO
WHAT IS YOUR CURRENT CAREER/JOB?
ARE YOU SEDENTARY OR IS YOUR JOB LABOR INTENSE?
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SEDENTARY, OFFICE JOB
MORE STEPS ONLY ON CERTAIN DAYS
VERY LABOR INTENSE JOB,HIGH ACTIVITY
Do you own an Apple Watch/fit bit (step tracker, HR monitor purposes):
Please put yes or no.
CURRENT DIET:
*
*Please list exact meal plan or portion sizes and what foods. if no current diet, type N/a and list what you eat.*
Any allergies/restrictions/disease to further discuss via consult call?
Yes
No
TRAINING/LIFTING EXPERIENCE:
*
Please Select
BEGINNER
INTERMEDIATE
ADVANCED
SO-SO
ANY INJURIES/SURGERIES WE NEED TO BE AWARE OF:
*
YES
NO
IF YES, PLS EXPLAIN:
PLEASE FEEL FREE TO LIST ANY ADDITIONAL COMMENTS HERE OR INFORMATION THAT COULD HELP US, HELP YOU-RIZE :
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