2023 Custom Coaching Application
Name
First Name
Last Name
Age
Height
Scale Weight
BF % if you know it
Email
example@example.com
What coaching style were you after?
VIP 1:1 Coaching (Weekly Checkins, Consult Call, Meal Plan & Voice Message Support)
Lifestyle coaching (Fortnightly Checkins, Macros & Flexible Dieting)
Why do you want to do Custom Coaching? What do you struggle with the most?
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Exercise History
Are you Beginner, Intermediate or Advanced?
How many training sessions do you currently do?
What is your Preferred Workout Split (2 upper body 2 lower body etc)?
Current Weight for Squat, Deadlift, Shoulder Press, can do Chin ups?
How many Sessions can you realistically commit to per week?
Do you have any injuries? (this will need to be cleared by a Professional)
Do you train at gym/home? If at home what equipment do you have?
How many steps do you do per day? (on avg)
What do you do for work?
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Nutrition History
How Many Calories do you eat per day (7 Day Average)?
What is your current Macro Breakdown (if you know - look at MyFitnessPal)
Do you tend to eat more calories on the weekend?
In the past 12-24 Weeks have you been in a deficit, at maintenance or above maintenance calories?
Do you have any history with Eating Disorders or anything we should know about?
How many times have you dieted this past year?
Do you feel better eating high, moderate or low carb?
What is your goal for this 12 Week Program?
Do you tend to undereat?
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Goals
Aesthetically, what is your MAIN FOCUS?
FAT LOSS
MAINTENANCE
REVERSE DIETING
BUILDING MUSCLE MASS
What is your Short Term Goal?
Do you have a longer term goal?
Performance or strength based goal?
Daily Habits you think will help you achieve your goal?
How Important are these goals to you?
TOP Priority, I will achieve my goals
Pretty Important but not my number 1 focus right now
Moderately important, would be nice to achieve them but other things are priority right now
Not bothered if I achieve them or not
What do you think you will need help with the most in order to reach your goals?
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Activity & Biofeedback
How many steps do you do per day? (on 7 day average)
Would you describe yourself as naturally a stressed person?
Are your stress levels usually low, moderate or high?
How many hours sleep do you get per night (on avg)?
Are Your Current Energy Levels
Low
Moderate
High
Are Your Current Hunger Levels
Low
Moderate
High
Do your currently have a regular cycle?
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So we know when to contact you - When would you like to get started?
ASAP - this weeek
In 1-2 weeks
Not sure yet
Submit
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