Dang Fitness 1:1 Online Coaching Application
Hey there! Please fill out this form to see if we're a good fit. I'll get back to you within 3 business days.
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CLICK HERE FOR DANG FITNESS WEBSITE
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Name
*
First Name
Last Name
Birth Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone Number
*
Format: (000) 000-0000.
Email
*
example@example.com
Please state if you have any health conditions and/or injuries.
Type N/A if none
Please state if you take any medications, vitamins, or supplements.
Type N/A if none
Health & Lifestyle
Rows
Yes
No
Comments
Do you smoke?
Do you drink alcohol?
Any past major surgeries?
Do you feel pain while exercising?
Do you have any limitations on your mobility?
Are you currently tracking your food intake?
How many days per week do you exercise?
*
Do you have access to exercise equipment? If home, list equipment. If gym, state gym name.
*
Do you own a wearable to track steps?
Yes, Apple Watch
Yes, Fitbit
Yes, other
No
What is your height?
*
Include unit of measurement (inches, feet, cm)
What is your current weight?
*
Include unit of measurement (lb or kg)
What are your health & fitness goals? Be as specific as you can and give a time frame if you are able.
Any other comments, concerns, or information that I need to know?
Type N/A if none
Thanks for your interest!
Submit
Completion of this form does not guarantee enrollment. In addition, once enrolled, payment is nonrefundable.
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