Blessup Fitness Coaching Application

What's your full name? *

First NameLast Name

How old are you? *

What's the best number to reach you at? *

Please enter a valid phone number.

What country are you from? *

What's your email? *

example@example.com

What's your instagram handle?*

What is your Facebook name?*

Where did you hear about me? Instagram? Facebook? Linked In? TikTok?*

What is your height(in feet)? *

What's your weight (in pounds)? *

What is your #1 fitness goal right now? *

What are you currently doing to work on this goal? *

How many days are you CURRENTLY working out weekly? Be HONEST please. :)*

What is your #1 struggle right now and how is it holding you back from your goal?*

How many days a week can you realistically see yourself dedicating to exercising?*

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Are you on any medications? *

Do you have any current or past injuries? If yes, please explain. *

Are you looking to train at home or in the gym? If at home, what equipment do you have? *

How many steps a day are you getting on average? *

Please walk me through a typical day of eating. Including ALL drinks, meals, snacks, supplements and at what times you eat all these things. BE AS HONEST AS POSSIBLE. *

Do you crave sugary foods often? *

Do you tend to fall of track during the weekend? *

How many times do you eat out a week? Please provide your go-to places. *

Do you drink? If so, what do you drink? And how often? *

Do you smoke? If so, what do you smoke? And how often? *

What are some of your favorite foods? *

What food do you dislike? *

Do you have any food allergies? *

What do you do for work? *

How active is your job? (sitting, standing, walking, physical labor, etc.)*

What are your short term goals? (1-2 months)*

What are your long term goals? (4-12 months)*

Why do you want to start now? Why do you want to make these changes in your health and fitness NOW? *

Please attach a front photo of your current physique.*

Please attach a back photo of your current physique. *

My coaching program is not a cheap *cookie-cutter* program. It's hands on 1-to-1 coaching tailored to your SPECIFIC goals and NEEDS. Why do you want to work with me? *

How long have you been following me for?*

When do you want to start your program? *

How committed are you to reaching your goals and making a transformation? *

What are your expectations working together?

I am going to teach you how to achieve your goals in a way you can sustain them for LIFE without dreading the process to get there. Are you willing to invest your TIME and ENERGY into this program, and trust me to deliver the results you want? *

I ONLY work with those who are 100% committed to achieving their fitness goals and taking their health, mindset, and fitness to the next level. Are you in a position where you're ready to FULLY committ to goals right NOW?*

I understand this program is extremely valuable and I am READY and CAPABLE to 100% commit to my goals!I understand this program is extremely valuable but I am on a tight budget. I will do everything in my power to make it work into my monthly budget as my fitness goals are very important to me.I am on a really tight budget right now and most likely cannot make this work

Did a friend refer you to me? If so, who? *

Who would you like to work with? If you're unsure, click "Pick for me" and we will pick the best fit based on your goals and expectations.

Coach CalliCoach HarleyCoach CourtneyPick for me :)