Prospective Client Questionnaire

1

Are you able to take a 15-20 minute call within the next 48 hours?* This field is required.If not, please don't submit yet. Re-apply when your schedule opens up

Yes

No

2

Name* This field is required.

First Name

Last Name

3

Email* This field is required.

example@example.com

4

Method of contact* This field is required.

Phone

Text

Email

5

Phone Number

7

What's your #1 goal in the next 12 weeks and why?* This field is required.

0/0

8

What have you tried in the last 12 months, and why didn't it stick?* This field is required.Examples: Keto, tracking macros, trainer, meal prep. What broke down? Time, consistency, cravings, stress etc.

0/0

9

How soon are you ready to start taking action?* This field is required.

This week

Within 2 weeks

Within 30 days

Not sure / someday

10

Which are you willing to do weekly? (multi-select)* This field is required.

Track nutrition 5+ days/week

Complete 3-5 workouts/week

Weekly check-in (photos/weight/notes)

Follow the plan even when motivation is low

Communicate within 24 hours

11

Which in the question prior will be hardest for you, and why?* This field is required.Be honest - this helps me coach you better.

12

Any injuries, limitations or medical conditions that affect training/nutrition? (If yes briefly describe)* This field is required.Not medical advice; consult your physician as needed

13

If accepted, are you ready to commit to the process for at least 12 weeks?* This field is required.

Yes

No

14

My coaching is personalized and results-driven, not cookie-cutter. It requires consistency and an investment. Which best describes you?* This field is required.

I'm ready to invest in coaching if it's the right fit

I'm open, but I ned to understand what's included first

I'm mostly looking for free tips / a basic plan

15

Final Step: Book Your Call* This field is required.Your application is only complete once you reserve a time below. This is a 15-20 minute call to review your goals and make sure this coaching is a good fit.