Online Coaching form
Part 1: Basic Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Gender
*
Female
Gender
Date of birth
*
-
Month
-
Day
Year
Date
Age
*
Height
*
Weight
*
Part 2: Lifestyle information
What do you do for a living?
*
How much activity does your job involve?
*
None (seated only)
Moderate (light activity such as walking)
Heavy ( heavy labour, very active)
Part 3: Medical and Health information
Do you have any injuries and medical conditions?
*
Do you currently exercise regularly? If yes, please provide as much information on your current routine (weight training, cardio, steps, sports etc.)
*
What is your current diet like week by week? (Do you track macros, fall off on weekends, eat enough protein etc?)
*
Part 4: Your goals
What are your main fitness goals?
*
How many days a week do you train/how many days can you train?
*
How quickly are you looking to achieve your goals? Do you have an occasion coming up?
*
When are you looking to start?
*
Have you had an online coach before?
*
Yes
No
As a coach, what are you looking for from myself?
*
Submit
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