COACHING APPLICATION

COACHING APPLICATION

Do you want to finally smash your health and fitness goals with me? Complete the questionnaire below!
Name

First NameLast Name
What is your age?
What is your height?
(feet)'(inches)''
What is your weight?
(lbs)
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Which form of contact is best to reach you at?
What's your Instagram handle?
What's you Facebook name?
Where did you hear about me?
(e.g. Instagram, Facebook, TikTok, LinkedIn, etc.)
Did a friend refer you to me? If so, who?
What is your current PRIORITY fitness goal?
What are you doing to achieve this goal?
What do you feel is holding you back from achieving this goal? (# 1 struggle)
How many days are you currently working out weekly?
How many days a week can you realistically see yourself dedicating to exercise?
Do you currently take any form of medication? If so, what?
Do you have any current and/or past injuries? If so, detail below.
Do you plan on training in a gym or from home? What equipment will you have access to if from home?
Please as accurately as possible detail all dieting habits throughout a typical day of eating, and times. (Breakfast, lunch, dinner, snacks, supplements, and DRINKS)
Do you often crave sugary foods?
Do you tend to diet poorly on weekends?
How often do you eat out in a week, if at all? What are your go-to choices?
Do you smoke and/or drink? If so, what and how often?
List some of your favorite foods.
List some of your not so favorite foods.
Do you have any food allergies?
What do you do for work or throughout the day?
How active are you during your daily activities or job? (Sitting, standing, walking, running, physical labor, etc.)
What are your short-term goals? (1-2 months)
What are your long-term goals? (4-12 months)
What has motivated you to change your life for the better and begin to work on your health and fitness?
How committed are you to achieving your goals and making a transformation?
What expectations do you have in regard to us working to help you achieve your goals?
When do you want to begin your program?
Please attach a photo of your current physique from the front.

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Please attach a photo of your current physique from the rear?

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The coaching and guidance you'll receive from my program are invaluable. For a fair cost you'll receive personalized hands-on coaching that is tailored to your specific goals and health needs. Are you ready?
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