PT & Online Coaching Form

1
Full Name* This field is required.
First Name
Last Name
2
Gender* This field is required.
Male
Female
Non-binary
3
Age* This field is required.
years
4
Height* This field is required.
cm
5
Weight* This field is required.
kg
6
First line address and post code* This field is required.
7
Email* This field is required.
8
Mobile Number* This field is required.
9
Instagram Handle* This field is required.
10
What is your occupation and your working hours?* This field is required.If applicable, include details on flexi-days or hybrid work schedules.
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11
What is your physical activity level right now?* This field is required.
Low (seated mainly)
Moderate (light activity - walking)
High (very active - exercise at least 4x a week)
12
Please tell me, in as much detail as possible: 1) What your goal is 2) Why this is important to you?* This field is required.
13
What are you struggling with right now?* This field is required.
What have you been trying? What are you working towards. that you feel you aren't achieving?
14
Describe your current eating routine and be honest 👀* This field is required.Mention your typical day - breakfast, lunch, dinner, snacks, guilty pleasures , frequent take aways etc.
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15
Do you have any nutritional allergies, intolerances and preferences?* This field is required.Are you a veggie, vegan, pescatarian? Include any food dislikes.
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16
In a "best case" scenario, and everything went to plan, where exactly do you want to be 3 months from now?* This field is required.
E.g. I'd like to have lost 10kg, be able to fit into my clothes better, not feel embarrassed when I take my clothes off, have more self confidence in my appearance, and feel happy about my body image.
17
Which of the following appeals to you?* This field is required.
Lose body fat and get leaner
Gain muscle mass
Improve self confidence (body image/mentally)
Gain education around Nutrition and Training
Receive personalised coaching to fast track your results
Other
18
On a scale of 1-10 how committed are you to making a serious change to your life?* This field is required.
1-3
4-7
8-10
19
Do you have any health/medical conditions or injury which would affect your ability to exercise? Please include any prescriptions also.* This field is required.
E.g. high blood pressure, arthritis, birth control pills etc.
20
Voucher Code
21
What service are you interested in signing up?* This field is required.
1-2-1 Personal Training
Small Group Coaching
Online Coaching
I want to enquire all options
22
What other training app are you currently using?* This field is required.
Runna
Coopah
TrainingPeaks
Other
None
23
To discuss everything in more detail and in the most efficient way, would you be available for a Facetime/Whatsapp video? We will also go over your best plan of action moving forwards.* This field is required.
Yes
No
24
With your details provided above, how would you like us to get back to you? (Please allow 24 hours)* This field is required.
Email (might end up in your junk/spam)
WhatsApp
Text Message
Social Media DM
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