New Client Application
Interested in some coaching??
Hey there! I'm so excited you're here and interested in working with me as your personal trainer! Please complete this form so I can learn a little more about you and it'll help me decide how we can best work together to help you achieve your healthy goals! I can't wait to get to know you!
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Instagram or Facebook name (if different)
Country
*
Before we move forward, how serious are you about working with me?
*
I might ignore you when you reach out
1
2
3
4
I'm ready to start now - let's to this!
5
1 is I might ignore you when you reach out, 5 is I'm ready to start now - let's to this!
Date of Birth?
*
-
Month
-
Day
Year
Date
What do you struggle with MOST?
*
Time
Motivation to work out
The ability to move how I want to
Discipline to a nutrition plan
Consistency and sticking to a plan
Other
What types of workouts do you enjoy/are looking for? Check all that apply.
*
No equipment needed
No/low impact
Yoga
Pilates
Strength Training
Cardio
Running
Cycling
Dancing
Pre/post natal
Kickboxing
Not sure
Not interested in workouts
What are you main goals in working with me? Check all that appy.
*
Weight loss
Sustainable Nutrition
Gaining strength
Gaining muscle mass
More mobility
Possibly getting off medication
Just getting healthier overall
Community of like-minded women
Accountability from me
1:1 coaching
Tell me a little bit about yourself and your health so far. What have you tried? What's worked? What hasn't?
*
Do you have any health concerns I need to know about? (type n/a if none)
*
I'm always going to keep it real - and making changes to our health can be difficult. How ready and committed are you to making a change?
*
just a tiny spark of readiness
1
2
3
4
I'm sooooo ready for a change!
5
1 is just a tiny spark of readiness, 5 is I'm sooooo ready for a change!
Any questions? Or anything else you'd like me to know about you?
That's it!
Can't wait to get to know you and help you reach your goals! I'll take a look at this and be messaging you within 24 business hours so watch your inbox!! XOXO Kelly
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