Online Fitness Coaching Application

Online Fitness Coaching Application

STRONG NOT STARVED
Personal Details
Full Name

First NameLast Name
Age
Gender
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
Company Name
Emergency Contact Person

First NameLast Name
Emergency Contact Phone No.
Please enter a valid phone number.Format: (000) 000-0000.
Best time to call

Hour Minutes

AM/PM Option

What are the things or ways that you do to manage stress?
How do you feel about your relationship with food?
What is a monthly spending amount you feel comfortable with for coaching?
Will you be exercising at the gym, from home, or both? (If home please list any equipment)

Terms and Conditions
- I confirmed that all information in this form is accurate and try to the best of my knowledge.
- I confirmed that I have read the contents of this form including these terms and agreement.
- I understand that Strong Not Starved will protect all the information in this form and will keep it confidential.
- I understand that Strong Not Starved accepts Zelle, Apple Pay, PayPal, and CashApp for payment methods.
- I understand that coaching doesn't guarantee specific results or outcomes.
Client Signature
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Rows	Yes	No	Occasional	Remarks/Notes
Difficulty of sleeping
Smoking
Drinking alcohol
Pregnant (Female)
Daily exercise
Surgical History
Drinking soda
Drinking caffeinated products

Personal Details