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Let’s See If Coaching Is the Right Fit for You
Fill this out honestly so I can understand your goals, your struggles, and if I can help.
16
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1
Full Name
*
This field is required.
So we know who we’re speaking with!
First Name
Last Name
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2
Email
*
This field is required.
You’ll receive important details about your application and next steps.
example@example.com
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3
Instagram Handle
If you want me to check you out or say hey.
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4
Phone Number
Drop your number if you're happy to chat via WhatsApp later on. Only if you're serious about moving forward.”
Area Code
Phone Number
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5
How would you describe your current fitness level?
*
This field is required.
Choose one.
Beginner – I have little to no experience with training or nutrition.
Intermediate – I have some experience but struggle to see results.
Advanced – I know what I’m doing, but I need expert guidance.
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6
What is your biggest struggle with fat loss?
*
This field is required.
Choose up to 2.
Lack of consistency
Emotional eating
Confusing information online
Motivation & mindset
Lack of a structured plan
Not knowing what to eat
Busy schedule & not enough time
Other
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7
Have you tried anything before to lose weight?
*
This field is required.
Select all that apply.
Strict dieting (Keto, Fasting, etc.)
Weight loss pills or supplements
Cardio-only approach
Strength training, but no structured plan
Worked with a coach before
Nothing serious, I’ve just been trying on my own
Other
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8
On a scale of 1-10, how serious are you about making a lasting change?
*
This field is required.
If it’s below a 7, this might not be the right time—and that’s okay.
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9
What is your #1 goal with your body and health right now?
*
This field is required.
Lose 20kg? Build confidence? Get lean? Feel strong? Be proud of your body? Be specific!
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10
Why is this goal important to you?
*
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What’s driving you? Why do you NEED this change? The deeper your "why," the stronger your results will be.
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11
How would your life change if you achieved this goal?
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Picture yourself 6 months from now, how would you feel? What would be different?
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12
What’s usually gotten in the way when you’ve tried to change in the past?
*
This field is required.
Be honest—life, mindset, habits? Choose up to 2.
Lack of knowledge on training or nutrition
No accountability or guidance
Lack of motivation or discipline
Struggling with emotional eating or cravings
Busy schedule & not enough time
I always start strong but fall off after a few weeks
Other
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13
Are you willing to invest time, effort, and resources into your transformation?
*
This field is required.
Choose one.
Yes, I know real change takes real commitment.
Yes, but I need some flexibility.
I’m not sure, I just want to learn more first.
Other
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14
My coaching program is a premium, high-level service that requires real commitment. Are you financially ready to invest in yourself?
*
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We offer different options, but this is a serious investment in your future health.
Yes—I’m all in and ready to transform.
Not right now—I’m just exploring.
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15
Anything else you’d like me to know?
Is there anything that would stop you from starting now?
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16
Next Step
*
This field is required.
Once you submit this form, I’ll send you an email with everything you need to know about how coaching works—pricing, how we start, and what’s included.
If it feels like a fit after reading it, you’ll have my WhatsApp contact to message me directly.
I understand and I’m ready to get the details.
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