Online Fitness Coaching Consultation
Please fill out this form to help me understand your fitness goals and create a personalized coaching plan for you.
Full Name
*
First Name
Last Name
Mobile Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Age
*
Gender
*
Male
Female
Other
Current Weight (in kg)
*
Height (in cm)
*
Goal Weight (in kg)
*
Activity Level
*
Please Select
Sedentary (little to no exercise)
Lightly Active (light exercise/sports 1-3 days/week)
Moderately Active (moderate exercise/sports 3-5 days/week)
Very Active (hard exercise/sports 6-7 days a week)
Extremely Active (very hard daily exercise/sports & physical job)
Occupation
*
Sleep Quality
*
Please Select
Very Poor
Poor
Average
Good
Very Good
Stress Levels (1-10)
*
Low Stress
1
2
3
4
5
6
7
8
9
High Stress
10
1 is Low Stress, 10 is High Stress
How Long Have You Been Training? (in months)
*
Training Frequency
*
Please Select
1-2 times per week
3-4 times per week
5-6 times per week
7 times per week
I am not currently training
Types of Training Enjoyed
*
Weightlifting
Cardio
Yoga
Pilates
HIIT
CrossFit
Running
Swimming
Other
Previous Injuries/Health Concerns
*
Current Diet (Please describe your typical daily meals)
*
Dietary Restrictions/Allergies
*
Gluten-Free
Dairy-Free
Vegetarian
Vegan
Nut Allergy
Shellfish Allergy
Other
Meals Per Day
*
Do you currently track your calories/macros?
*
Yes
No
Primary Fitness Goals
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Expectations from Coaching
*
Biggest Challenges You Anticipate
*
Commitment Level
*
Please Select
Very Committed
Moderately Committed
Somewhat Committed
Do you have access to a gym or do you prefer home workouts?
*
Gym
Home Workouts
Both
Available Equipment (If you prefer home workouts, please list the equipment you have available)
*
Additional Information (Anything else you'd like to share with me?)
*
I agree to the terms and conditions.
*
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