1 on 1 mentoring
Structured to you and your goals
Name
*
First Name
Last Name or initial
Email
*
example@example.com
Age
Height
Weight
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Goals and Context
Please provide any goals and requests for mentoring
What is your primary goal?
*
(Fat loss, muscle gain, recomposition, consistency, etc)
What is your biggest frustration currently?
*
(Discipline, structure, motivation, etc)
How long have you been training consistently?
*
Less than 6 months
6-12 months
1-3 years
3+ years
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Dieting and Training history
Have you dieted before?
*
If yes, what methods have you tried?
What causes you to fall off track?
*
(Work, kids, travel, cravings, etc)
How many days realistically can you train?
*
2-3 days
3-4 days
4-5 days
5-6 days
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Readiness and Expectations
Can you commit to a structured plan?
*
We provide structure please list any potential conflicts
On a scale of 1-10 how ready are you follow a plan?
*
1-10
Which best describes you currently?
*
I need structure and accountability
I need fine-tuning and adjustment
I’m not sure but I’m open to guidance
I just want more information about the program
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Logistics and Transparency
Are you comfortable tracking food and body weight (including weekly check in photos) as part of the process?
*
Yes
No
Unsure
Coaching starts at $50 per month, is this within your budget currently?
*
Yes
No
I’d like to discuss options
What does success look like for you 3 months from now?
*
Short term goals (discipline improvement, x weight loss, consistency)
Finish
We look forward to helping you along your journey, we are here to help not to judge. Our goal is to get you the results you want, you just have to put the work in! Thank you for filling out the form and we will be in touch within 24 hours.
Anything else you’d like to share?
*
free text for anything we might have missed.
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