Personalized Fitness Coaching Application

1

What is your full name? * This field is required.

First Name

Last Name

2

What is your phone number? *

Please enter a valid phone number.

3

What is your email address? *

example@example.com

4

How did you hear about us?

Google

Instagram

Facebook

Tiktok

5

What is your biggest struggle right now? *Please explain in detail so we can determine which program you would be the best fit for.

6

Have you ever worked with a coach before?* This field is required.If yes, what worked and what didn't? If no, what made the decision that now is the time?

7

What motivated you to show interest in Physique World specifically? *

8

On a scale of 1-10, how committed are you to making a real change?* This field is required.

1
2
3
4
5
6
7
8
9
10

Not ready

All in!

9

What is your desired goal?* This field is required.

Build Muscle

Lose Weight

Maintain

10

Are you the sole decision maker when it comes to investing in coaching, or does someone else need to be involved?* This field is required.

I make my own financial decisions

I discuss investments with my spouse/partner

11

My coaching requires a financial investment. Are you in a position to invest in YOU to see results?* This field is required.

Yes! I am ready to invest in ME

I need to figure out the finances but I am serious about making it happen

I cannot invest $100 a month or more in myself

12

How much are you willing to invest?* This field is required.

$0-100

$100-500

$1,000- 5,000+

13

Time is one of the biggest excuses people use to delay change. Are you willing to prioritize 2 - 4 hours per week to this program until you hit your first fitness goal?*

100% I will make time, no matter what!

I'm busy, but will make it work

Not sure if I can commit right now

14

What industry do you work in, what is your role?* Please be specific to your activity levels during work hours.

15

I understand that for this call I need to be in a quiet and in a present place and that I am coming ready to take action*

YES, I will be there!NO thanks.

16

User ConsentBy continuing, you agree to the collection and use of your personal data in accordance with our [Privacy Policy]. Your data may be used to improve your experience and for service-related purposes.

I agree