Online Coaching Application Form

Online Nutrition Coaching Application

This is an application to work with our head of nutrition at Amplified Athletics, Jennifer Velasquez
Name

First NameLast Name
Email
example@example.com
Instagram Handle (ex. @thefightfuelcoach)
We would love to give some free resources and connect with you on social media.
Why do you want to work with a nutrition practitioner?
If you are a combat or weight classed athlete, what weight class do you compete in?
If you are a combat or weight classed athlete are you looking to move up, down or remain at the same weight class?
What is/are your current fitness/performance goal(s)?
Are you also looking for online/app based coaching for strength and/or conditioning?
What are your biggest challenges or obstacles with your nutrition?
Do you currently use any food tracking app, or have you consistently used one in the past?
Are you looking for a structured/strict meal plan, grocery lists and recipes or does something a bit more flexible sound appealing to you?
What do you expect or want out of nutrition coaching with us?
On a scale of 1-10 how disciplined would you say you are? Disciplined being that you will do what needs to be done, regardless of how you FEEL about the task at hand.

1

2

3

4

5

6

7

8

9

10

1 is My feelings dictate my life, 10 is I do EVERYTHING that needs to be done.
On a scale of 1-10 how motivated are you to make a change in your nutrition habits and change your performance and health?

1

2

3

4

5

6

7

8

9

10

1 is No motivation, 10 is Motivated like my life depends on it
What do you do for work? (accountant, retail manager, etc.)
Is your job pretty active or are you relatively sedentary throughout the day?
What's your phone number including your international and local area code?

Country CodeArea CodePhone Number
How are you approaching this consultation call?
Is there anyone else involved in the decision-making process who should join in on our consultation call? Please ensure they can also be present during our call.
Once you submit this application we will contact you if you qualify for our program to set up a free consultation call.
Please verify that you are human
Should be Empty:

Online Nutrition Coaching Application