1:1 Coaching Intake Form
Please answer a few questions to get us started. There is no obligation to sign-up upon filling out this form.
Full Name
First Name
Last Name
Preferred pronouns
She/her
He/him
They/them
Email
example@example.com
Age
Weight
lbs
Height
Feet & inches (Ex. 5"7)
Have you worked with a personal trainer or online fitness coach before?
Yes
No
How often do you currently exercise?
Never
1-2 x per week
3-5 x per week
More than 5x per week
What type of exercise do you typically do? (Select all that apply)
Walking
Running
Sports (soccer, volleyball, tennis, etc.)
High-intensity interval training
Resistance training/Strength training
Weightlifting/Cross-fit
Other
What is your comfort level in the gym?
I rarely visit the gym/I'm not confident with gym equipment
I go the gym sometimes/I'm somewhat confident at the gym
I go to the gym regularly/I'm fairly confident at the gym
I go to the gym regularly/ I'm very confident at the gym
What is your goal in joining my coaching program? (Select all that apply)
Lose weight
Lose body fat
Build muscle and strength
Improve overall health and fitness
Look more toned
What has held you back from achieving this goal on your own?
Submit
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