Online Coaching Application
Amy Nolan Fitness
Part 1. Basic information
Full Name
First Name
Last Name
Email address and number
Email
Gender
Male
Female
Age
years
Height
cm
Weight
KG
Part 2. Lifestyle Information
What do you do for a living?
Whats the activity level at your job?
None (seated only)
Moderate (light activity such as walking)
High (heavy labor, very active)
Please list the physical activities that you participate in outside of the gym and outside of work
Part 3. Medical and Health Information
If you have any diagnosed health problems list the condition(s).
If you have any injuries, please list them.
Are you experiencing any stresses or motivational problems?
Yes
No
Part 4. Goals
What following goals does best fit in with your goals?
Improved health
Improved endurance
Increased strength
Increased muscle mass
Fat loss
What is your goal with your training? Why?
How often are you willing to train a week to reach your goal?
Will you train in the gym or at home?
Gym workouts only
Home workouts only
Mix of both gym and home workouts
Can you stick to our step goal of 10k steps a day?
Yes
No but will try
Submit
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