1:1 Habit Training Inquiry Form
Help me understand you and what you want out of this experience so I can learn how to best help you. This form is for people outside of my in-person work radius.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Age
Sex
Please Select
Male
Female
Prefer not to say
What are your health goals? Why are these goals important to you?
Have you tried to reach this goal before? How did it go?
What kind of time/effort do you have to devote to your own health?
What obstacles have kept you from achieving the life you want?
Are you under the care of a doctor? Are there any health concerns or physical limitations we should take into account for your training?
What does a typical day look like for you?
Be honest here. If you regularly get home from work and eat a pint of ice cream, no shame. We've all been there.
What do you expect my role to be in your health journey?
Submit
Should be Empty: