YSM ATHLETE QUESTIONNAIRE
Hello! Thank you for reaching out and your interest in receiving coaching from me. Please fill out this questionnaire as accurately as you can to allow me to better assess your needs and goals and to understand your experience in powerlifting/strength training. Along with completing this form, please also fill out the waiver form (link included at the bottom). Please understand that filling this form does not guarantee you a spot for coaching. I will reach out to you in a few days to discuss next steps.
Full Name
*
First Name
Last Name
Gender
*
Male
Female
Country
*
Phone Number
-
Area Code
Phone Number
Job Profession?
*
Email
*
example@example.com
Age
*
years
Preferred Method of Contact?
*
Instagram
Text
Email
Desirable Start Date
*
-
Month
-
Day
Year
Date
Instagram
*
Current Bodyweight?
*
Years of Powerlifting/Strength Training?
*
How Many Days Do You Lift/Week including Squat, Bench, Deadlift?
*
Current Squat 1RM
*
Current Bench 1RM
*
Current Deadlift 1RM
*
Main Squat
*
High Bar
Low Bar
Main Deadlift
*
Conventional
Sumo
Are you Familiar with RPE? (Rate of Perceived Exertion)
*
Yes
No
Past injuries?
Past programs you've been on if any?
Have you ever been coached before?
*
Yes
No
If you have, why did you decide to leave?
How did you hear about me?
*
Instagram
Friend
Other
If stated other, please mention below
What are your specific goals you would like to achieve?
*
How much would you be willing to invest per month to have your strength, physique, and life completely changed?
*
Less than $150
$150-200
$200+
Please Fill out Waiver Form: (https://form.jotform.com/91736583898175)
*
Yes, I have filled out the waiver form
Submit
Should be Empty: