Online Coaching Consultation Form
It looks like a lot, but this form will give us all the information we need to tailor your coaching to you!
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Gender:
*
Please Select
Female
Male
Non-binary
Other
Prefer not to say
Was this the gender you were assigned at birth?
Please Select
Yes
No
Prefer not to say
What are your preferred pronouns?
*
Date of birth:
*
Height:
Current weight (if know / relevant to your goals)
Do you have any medical conditions or take any medication?
*
Yes
No
If you answered yes, please give more detail:
Your Goals
Tell us more about what you'd like to achieve through coaching!
What would be your dream outcome by the end of coaching
*
How long have you given yourself to reach this goal?
*
Lifestyle Information:
How active are you on a daily basis?
*
Very sedentary
1
2
3
4
5
6
7
8
9
Very active
10
1 is Very sedentary, 10 is Very active
Do you currently train at a gym? If so, give detail about your current routine
*
How many steps do you hit each day?
*
Do you take part in any other activity / exercise outside of walking or the gym?
*
How much sleep do you get a night on average?
*
How would you describe your sleep quality?
*
Very poor
1
2
3
4
5
6
7
8
9
Great!
10
1 is Very poor, 10 is Great!
How much water do you drink a day?
*
< 1L
1-2L
2-3L
3-4L
>4L
How would you describe your typical stress level?
*
Very low
1
2
3
4
5
6
7
8
9
Very high
10
1 is Very low, 10 is Very high
Nutrition
Give us an overview of what a typical day looks like for you nutrition wise:
*
Have you tried any specific nutrition protocols in the past? If so, give details on if it was effective and / or enjoyable for you:
Please list any supplements you're currently taking:
Training
How many times a week do you think you will be able to REALISTICALLY commit to exercise?
*
1-2
2-3
3-4
4-5
How long would you typically like to spend exercising?
*
Are there any areas you'd like to focus on more in your training? Please list them in order of importance:
Do you want your training to be gym based, home based or a bit of both?
*
Gym based
Home based
Bit of both
Not sure
Please list any forms of exercise / movements you love!
Please list any forms of exercise / movements you don't enjoy:
Motivation
Whats made you reach out for online coaching now?
*
What do you believe have stopped you from achieving your goals in the past?
*
Are you ready to invest in yourself for as little as £4.80 a day?
Please Select
Yes!
Not quite yet
How would you like us to reach out to you to book in your complimentary consultation call?
*
Phone
Email
WhatsApp
Submit
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