Coaching Application
Please take some moments to fill this form out with as much information as you can. Your answers will help guide our next steps.
Full Name
*
First Name
Last Name
Birth Date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
What is your main goal?
Muscle Building
Fat loss
Competition
General Health
What services are you interested in?
Strength Coaching Only
Nutrition Coaching Only
Strength and Nutrition Coaching
What have you tried in the past year to get to your health/fitness goals?
What are your 3 main issues making it harder for you to get to your goals?
What would you like a coach to do for you and have you ever worked with a coach?
Any additional issues you would like to discuss during your phone call:
Do you have recent bloodwork from your doctor?
Yes. I’d like coaching that takes my doctor-reviewed labs into account
No, but I’d be open to it
No
Do you have any injuries or medical conditions I should know about?
What do you do for work? How physically and emotionally taxing is it?
What is your current stress level & what is your biggest current stressor?
How do you handle adversity or training set backs?
What motivates you most? results, structure, variety or coaching, etc?
Tell me about your home life?
What does a typical day look like for you? Wake time, morning/daily routines, kids, pets, workouts, etc?
Where will you be training? If at home, please tell me about the equipment you have.
How familiar/comfortable are you with structured training?
How familiar/comfortable are you with tracking macros, meal plans, etc?
Describe your current daily nutrition. Meal times, macros if known, water intake, etc.
What is your current biggest struggle when it comes to nutrition?
How many days a week can you realistically train? How many minutes/day?
The investment for coaching ranges from $250-$450/mo depending on the best fit. Are you ready and willing to make this investment in yourself if we decide to move forward?
Absolutely
Not at this time
Our coaching relationship requires consistency, communication and follow-through. Are you ready to be coached and guided through the process?
This call is dedicated 100% to you. Do you agree to take the call in a quiet, uninterrupted setting (not driving, walking or multitasking)?
Why now? What changed that made you decide to start now?
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