Kegels n' Kettlebells 1:1 Online Fitness Training Application
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E-mail
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Instagram Handle
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Have you ever been diagnosed or treated for any chronic disease including asthma?
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No
If yes, please specify
Are you currently pregnant or nursing?
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Any other conditions that we need to be aware of (i.e. Pelvic floor dysfunction, Past or present injuries, etc)?
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Please rate the following. One star being negative to five stars being positive
I have a positive attitude towards things
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5
My job stresses me out.
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5
I am in the best shape of my life.
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5
I would rate my current health.
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5
I am serious about acheiving my goals
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5
What are your current goals? Select all that apply.
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Pelvic Floor + Core Training
Fat loss
Build Muscle
Consistency + Mindset
Other
Why do you think you have not been successful in the past in reaching these goals?
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Are you currently following a workout routine?
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Yes
No
Sometimes
If yes, please specify
Are you currently tracking your food intake (calories and/or macros)?
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Yes
No
Sometimes
If yes, please specify
Coaching is an investment into your body, your health, and yourself. Are you ready to make that financial investment?
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YES!
I'm not sure
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