FitMama Coaching Application

1
Ready to take control of your body and feel amazing inside and out?* This field is required.This is what we do so I just want to make sure :)
YESNO
2
How would you describe your current body type?* This field is required.Please select all that apply
Postpartum - Just delivered baby within 1 year
Skinny - need to add some tone
Skinny fat – Stuck in the fluffy middle with a bit of a mommy pouch
Medium - I look fairly normal I would say
Chubby - I am soft around the edges
Overweight - I am overweight
Obese - I am more than 50lbs over weight
Bottom heavy - Top is toned but legs are not
Top heavy - legs are toned but upper body is not
Prefer not to say
3
Which of these diet fads have you dabbled in before?* This field is required.Please select all that apply
Keto
Intermittent Fasting
Herbalife/Optavia/Thrive
Whole 30
No carb / Low carb
Atkins
Vegan/Vegetarian
Sugar free
Gluten free
Macros
Paleo
None of the above
Other
4
How would you rate your knowledge of macronutrients?* This field is required.
Advanced
I know a lil something
Beginner
Tried and didn't work
5
Macronutrients are an overall approach to food that when used correctly gives you immense control over your body composition

Benefits:

Controlling your body and the way it looks

Sustainable and long term approach

Flexibility of eating foods you enjoy

Living life without 2nd guessing your diet
6
Which of the following best describes your current situation?* This field is required.Please select all that apply
I am trying really really hard with my workouts & diet, but I can't get F*cking toned for the life of me. No matter what I do, I still have a soft fluffy look.
I have no idea any more when it comes to my diet, macronutrients, and nutrition. Everywhere you go someone is saying something different. I have no problem putting in the work. I just want to know I am doing the right things.
I was out of shape, and began to make progress, and now my results have stopped and it's become discouraging. I don't want to fall out of shape again but it's becoming hard for me to keep pushing forward when I am not seeing results.
I'm using macronutrients, this flexible dieting works for me, and has helped me make progress. But now I'm seeing that there might be more to this than I initially thought... And I want answers.
Food controls me. I am so unsure about what I should be eating, and if I am doing the right thing, that every morning when I wake up, I feel a sense of worry. This is unhealthy and I want to fix it.
I feel like I'm on a roller coaster. I can get in shape but I do it in ways that burn me out over time and I just can't sustain it. I want to learn something sustainable so I can get results that last.
I have been out of shape for quite sometime. I need a full blown reboot. I need you to believe in me because I am not sure I believe in myself anymore.
I feel like I'm in pretty good shape. I just want to take things to the next level. I have pushed my experience to its limits and I am looking for more.
I am really uncomfortable in my skin, and it is beginning to wear down my confidence levels, and is starting to affect my relationships & other areas of my life.
Other
7
Rate your current satisfaction level with your body at this exact moment* This field is required.Slide the smiley face.
Row 0, Column 0Row 0, Column 1Row 0, Column 2Row 0, Column 3Row 0, Column 4
Row 0, Column 0Row 0, Column 1Row 0, Column 2Row 0, Column 3Row 0, Column 4
8
How serious are you about fixing this, like, right now?* This field is required.
5/10 - I don't want to improve my situation that much and am OK not making more progress than I have now
7/10 - I am pretty frustrated with things right now, and want to get them figured out... The sooner the better
9/10 - This is affecting my confidence, energy, and how I am showing up in life. I want to fix this ASAP!
10/10 - I will literally do anything to get this situated, I do not want to go on one day longer without a sustainable, healthy, long term program that will improve my body composition, and make me feel better
9
Where would you like to be 6-12 months from now?* This field is required.Please select all that apply to you
I want to feel like I am in control of my body and the way it looks
I want to enjoy my outfits & taking pictures with my family
I want to have energy so that I can be outgoing with my friends & family again
I want to feel free from food and the guilt that comes with not understanding it.
I want to feel like I can do this myself, and am not dependant on a trainer / nutritionist
I want to drop 10-15 lbs of fat
I want to drop 20-25 lbs of fat
I want to drop 30+ lbs of fat
I want to add lean muscle tone
I want to feel healthy enough to get pregnant
I want to live a healthy lifestyle that I can pass onto my kids
Other
10
What’s really holding you back from crushing these goals?* This field is required.Please select all that apply to you
I have a hard time sticking to a diet... I think because I have a hard time believing it will work long term.
I can stick to a diet, they just always stop working after a certain point, and then I quit them.
I have no problem putting in the work, I just am not sure on what I'm supposed to do!
I have trouble trusting the process and need something full proof that I can understand myself.
I don't have the right knowledge. The confusion is causing inaction and I am done with it.
I have a hard time committing and need a heavy element of accountability & support.
I don't have a community or people around me who think like me and can support me.
I don't have any expert coaches, or advice that helps me get back on track.
Other
11
What other roadblocks are standing between you and your BEST self?* This field is required.
12
What are the most important goals you want to reach? And please explain why you need FitMama's help.* This field is required.
13
Are you prepared to take action RIGHT NOW to invest significant time, energy, and finances into yourself to reach your goals if you knew with 100% certainty that you would get there?* This field is required.
Yes, absolutely!
No, I am not ready yet.
14
Our 1:1 coach program is $500-$750 per month. Is this a price range that works for you?* This field is required.
YESNO
15
Totally understandable, we also have the options to use HSA/FSA benefits or financing through Affirm which can bring rates as low as $155/mo. Would that work better for you?* This field is required.
YESNO
16
If accepted into our program how soon can you get started?* This field is required.
17
Name* This field is required.
First Name
Last Name
18
Age?* This field is required.
19
Email* This field is required.
example@example.com
20
What phone number can we use to reach you? (just so we have the right one on file)* This field is required.By entering your phone number, you consent to receive messages for this event via SMS. Message and data rates may apply. Reply STOP to opt out.
Area Code
Phone Number
21
How did you hear about us?* This field is required.
Instagram
TikTok
YouTube
Friend
Coach Rhea
Coach Milly
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