Client Coaching Application
Optimal Vitality HQ is built on commitment, consistency, and coaching not drop-ins or quick fixes. This application helps us determine if we’re the right fit to support your health, performance, and lifestyle goals.
BASIC INFORMATION
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Age Range
*
Please Select
>25
25-34
35-44
45-54
55+
GOALS & CURRENT STATUS
What are your primary health or fitness goals right now?
*
Examples: building strength, losing body fat, improving mobility, reducing pain, creating consistency, or improving overall lifestyle health.
How would you best describe your current training routine?
*
I train consistently (3+ times per week)
I train occasionally but struggle with consistency
I am returning after time off, injury, or burnout
I am new to structured training
How important is improving your health and performance right now?
*
Not a priority
1
2
3
4
Top priority in my life right now
5
1 is Not a priority, 5 is Top priority in my life right now
COMMITMENT & STRUCTURE
Optimal Vitality HQ operates on a commitment-based coaching model (4, 8, or 12 months). Which option are you open to exploring?
*
4-month commitment
8-month commitment
12-month commitment
Not sure yet, open to discussion
How many in-person coaching sessions per week can you realistically commit to?
*
1x per week
2x per week
3x per week
Are you willing to commit to a consistent training schedule with assigned days and times?
*
Yes
No
AVAILABILITY
Which training times work best for you? (Select all that apply)
*
Early Morning (7:00–10:00 AM)
Midday (11:00 AM–2:00 PM)
Afternoon (3:00–6:00 PM)
Evening (6:00–8:00 PM)
MINDSET & FIT
Are you looking for coaching, accountability, and long-term guidance — not just workouts?
*
Yes
No
Why do you feel now is the right time to commit to your health?
*
Please review and acknowledge the following:
*
Statement: I understand that Optimal Vitality HQ does not offer drop-in sessions or session rollovers. Coaching is delivered through structured commitment plans designed for long-term success.
How did you hear about Optimal Vitality HQ?
Please Select
Referral
Social Media
Website
Event / Community
Other
Submit
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