Please Complete This Application
Please BE HONEST.
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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-
Area Code
Phone Number
Your Instagram Profile name:
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Occupation
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Age & Weight
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Do you feel like you need help?
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Yes
No
Not sure
What is your goal? Lose 20 lbs? Gain 20 lbs. of muscle? Overcome depression? Be specific. Doesn't just have to be a physical goal.
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What would be the most important criteria for your success as we work together?
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What have you tried in the past and why hasn't it worked for you? What's stopping you from hitting your goal?
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On a scale of 1-10... 1 being I'm satisfied where I am and 10 being I'll do anything to reach my goal. What number are you?
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Does your spouse or significant other support you? (Meaning they will give you a thumbs up on whatever you decide)
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Yes
No
Not applicable
What would you expect from us as your coach if we decide to work together?
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If accepted how soon are you looking to get started? (if you aren't ready please just wait and schedule when you can. We expect those who feel it's a fit to move forward. Those who don't take actions are 95% more likely to continue to do nothing).
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Submit
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