Client Application
Please fill out the information below. You will be able to schedule your consult at the end of this form.
Name
First Name
Last Name
Email
example@example.com
Phone Number
What are your goals? (Select all that apply)
*
Weight-loss
Weight-gain
Strength Training (Tone/Build Muscle)
Endurance (Runners, swimmers, preparing for races and/or events)
A Consistent Workout Routine
Other
What is your current exercise schedule? If you do not have one, put down times you can commit to exercise; days of the week, and the times. Now is your time to think about what you want that routine to look like in the future if it is non-existent.
Will you be exercising at home or at a gym?
*
Home
Gym
Both
If working out at home, what type of equipment do you have? (Dumbbells, Kettlebells, Bands)
What is your training preference?
Online
Hybrid (Includes Virtual Sessions)
In Person
How active are you? Do you currently workout?
*
Do you have any injuries?
Yes
No
List three different days and times you are available for a consult? Virtually or in-person.
What is your budget range for fitness? (How much can you dedicate to your health and wellness each month?)
$100-300
$300-500
$500-1,000
$1,500+
Choose a time you are available for a consult.
*
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CONSULTATION
If you are interested in online training, your consult will be via zoom. If you are interested in in-person training, your consult will be in person.
$
25.00
Payment Methods
Credit Card
ACH Bank Transfer
Submit
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