Application Form
Ready to seriously crush some serious goals while enjoying the process and learning invaluable skills and knowledge you won’t be able to find anywhere else with any other coach or even medical professional? Let me help you! Fill out this form to the best of your knowledge and as much detail as possible before your free consult!
Name
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First Name
Last Name
Birth Date
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Year
Gender
*
Please Select
Male
Female
N/A
Mobile Number
*
Format: (000) 000-0000.
Best E-mail
Height
*
Weight
*
Goals
What are your top 1-3 goals you’re looking to accomplish?
*
What’s preventing you from reaching those goals?
*
Please Select
Lack of motivation
No support system
Lack of knowledge (don’t know how to)
Lacking confidence/ self esteem
Lack accountability
Procrastinating
Do you track your intake? Meal prep or eat out? If so, please provide your daily calories and or macros (or best estimate)
*
If you have any diagnosed health problems list the condition(s). If you are on any medications, please list them.
How many days do you go to the gym? Please describe what kind of workouts you do and for how long. (Ex: resistance train push pull legs split 4x a week 1.5 hours each, cardio 3x a week stair masters level 8 30 minutes each, Sunday full rest day.) Outside the gym do you participate in other physical activities? Please be as detailed here as possible.
*
At what times during the day would you prefer to train?
*
Morning
Mid-Day
Afternoon
Evening
Please attach current front and back photos
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If you have any injuries, or past medical or mental conditions (depression, anxiety, eating disorder, trauma, etc), please list and explain.
How much sleep do you get per night?
Less than 6hrs
6hrs
7hrs
8hrs
9hrs or above
Lifestyle and Nutrition
What type of health supplements are you currently taking? Brand, flavor, and type listed please (or just name of product and flavor if applicable). Include any hormones and peptides or injections if applicable.
How much water and how much coffee/caffeinated beverages are you drinking per day?
Have you had, any blood work done? Any abnormalities?
Yes
No
Please attach file or list our abnormalities below, as well as any diagnosed medical conditions and symptoms
Do you have any known food intolerances or foods that you prefer not to eat?
*
What does your current diet look like? More detail the better
What’s your most unhealthy foods you eat out or often, or what do you crave most?
What’s your favourite healthy foods?
Anything else you would like to share! Anything relevant that would help me personalise your plan or even fun facts! Feel free to reach out via dm on Instagram @sabrinafan.fitness and thanks so much die your interest! Once I finish reviewing your submission I’ll reach out to schedule a FREE phone/video consultation! Please leave down your instagram handle or any other social media/forms of communication. Also please share what state you are in for time zone differences.
Terms & Conditions
1.) CANCELLATIONS Initial plan and upfront payments are non-refundable however monthly coaching can be terminated at any time.2.) UPDATES Updates must be sent as scheduled with front and back photos attached and current weight average week weight unless you have made your coach aware in advance of something preventing this or in the case of an uncontrollable event taking place preventing this. Update photos must be sent weekly as well as weight. 3).ALL OF THE INFORMATION I HAVE GIVEN IS CORRECT All of the information on this form is correct to the best of my knowledge. I understand that all the information given will be kept strictly confidential.4.) MEDICAL HEALTH I have sought and followed any necessary medical advice. I am fit and able to begin a diet and/or training program. I have no known existing medical conditions that I have not mentioned above.
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