Macro Coaching Application

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Name* This field is required.
First Name
Last Name
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Email* This field is required.
example@example.com
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Phone Number* This field is required.
Please enter a valid phone number.
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What are you interested in?
1:1 Coaching
One Time Consultation
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What is your Instagram name? Type "N/A" if you aren't on Instagram.* This field is required.
6
When is your birthday? (How old are you?)
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Have you counted macros in the past?
YESNO
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What are your health/fitness goals?* This field is required.
Lose weight
Gain weight
Maintain weight
Feel better
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What is your dieting history (What have you tried in the past? For how long?)* This field is required.
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Are you on any special diet currently? (Ex. vegetarian, no dairy, keto, etc.)
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Ok
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What do you do for work? What are your typical hours?
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How tall are you?
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How much do you weigh?
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Are you a parent?
YESNO
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I do not take my post partum clients into a deficit until they are at least 6 months postpartum. If you've recently given birth, please acknowledge that you are aware of this policy.
YESNO
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How many steps do you get (on average) each day?
0 - 3000
3000 - 6000
6000 - 9000
9000+
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Do you have any medical problems?
YESNO
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If yes, what conditions(s)? If not, type "N/A".
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What type of exercise do you get? Describe in detail. (If strength training, what kind/program and how many days per week? If cardio also, what kind and how many days per week?)* This field is required.
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What are your nutrition frustrations/road blocks?
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I'm looking for clients who are ready to do the work it takes to become their healthiest selves. Is that you? Why?* This field is required.
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Ok
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What are your hobbies?* This field is required.
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Is there anything else you'd like me to know about you?
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Were you referred by someone? If so, who? If not, type "N/A".* This field is required.
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My 1:1 macro coaching is $250/month with a minimum of a 3 month commitment. After your first 3 months, your contract will then be month to month. This is consistent with industry standards for a reputable coach. Are you comfortable with the investment and commitment?* This field is required.
Yes! I'm ready to start!
I'd like a 1:1 macro count instead ($70). Does not include continued guidance.
I'd like to talk about it which would be best for me and my goals.
I don't think I'm ready right now but would like to remain on your email list for first dibs on any future offerings.
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Please note that you will be added to my email list. (You may choose to unsubscribe at any time.)
Add me to the list!No, thank you.
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If you've chosen a one time macro count, please make payment below. (Please note, if no payment is received, you count will not be performed.) Once payment is received, you'll be directed back to this form for completion.
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ORDER SUMMARY
Total costUSD
One Time Macro Count
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Total cost
Payment Methods
First Name
Last Name
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If you decided 1:1 coaching is for you, let's hop on a call and decide if we're a good fit! (Scroll down if you prefer another option.)
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If you've selected 1:1 coaching, how do you prefer I contact you initially? (We will be in contact via my app once you're onboarded.)
I've already set up a Zoom call
Phone Call
Email
Instagram DM
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Please verify that you are human* This field is required.
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