Online Coaching Application
The first step to changing your life.
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Age
Gender
Male
Female
Other
Prefer not to say
Please provide a brief description of your current situation. (This may include how active you currently are/ your current lifestyle/ your current relationship with food/ your current relationship with the gym)
Which statement best describes you?
Total beginner
I have some gym experience but not sure how to get the results I'm after
I have a good knowledge of training and nutrition but need help getting to the next level
Please provide a brief overview of your previous training experience (i.e how experienced you are with training, handling your own healthy eating etc).
Do you have any medical conditions or injuries?
Yes
No
If you ticked yes, please give details.
Have you previously worked with a Personal Trainer or Online Coach?
Yes
No
If you ticked yes, please give a brief description of your experience? i.e Positive or negative.
What are your overall goals? Please share one short term and one long term goal you would like to achieve:
What is it that you feel is currently getting in the way of achieving your goals?
What is your biggest motivation for making a change?
What is your current occupation and how many hours per week do you currently work?
Why do you want to work with Coach Connor?
How motivated are you to change?
Not at all
1
2
3
4
Very
5
1 is Not at all, 5 is Very
If you would like to add anything else for me, any notes at all, please include here:
Submit
Should be Empty: