Starting My Transformation
Congratulations on taking your 1st steps to your transformation journey. After filling this form out, Coach Nancy will be reaching out via text to set up a time to understand your needs and get you started. Thank you for considering Choosing Me: Health & Fitness!
Client Name
First Name
Last Name
Phone Number
Format: (000) 000-0000.
Email
example@example.com
What state do you live in?
How often can you exercise per week?
Please select the best days you can exercise.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Please select the best times you can exercise.
Early Mornings
Mornings
Early Afternoons
Afternoons
Evenings
What are your goals for training?
Development of muscles
Reducing the stress
Losing body fat
Increasing the motivation
Training for an event/specific sports
Other
How would you like to workout?
*
In-Person
Virtual
What is your rate for your nutrition?
Poor
0
1
2
3
4
Excellent
5
0 is Poor, 5 is Excellent
At which frequency you eat breakfast?
Never
0
1
2
3
4
Always
5
0 is Never, 5 is Always
At which frequency you eat at night?
Never
0
1
2
3
4
Always
5
0 is Never, 5 is Always
Submit
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