~PHILLY DEE FITNESS ~ Client Transformation Questionnaire 👇🔥
Complete this questionnaire to help us understand your goals, challenges, and commitment for a personalized transformation plan.
Vision & Goals
What is your #1 goal right now across your physical, mental, and emotional well-being? Be specific about what success looks like in 12 weeks.
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Why is this goal important to you, and how will achieving it impact your life, confidence, and family?
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Current Reality
Current health, fitness, and mindset rating
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Low
1
2
3
4
5
6
7
8
9
High
10
1 is Low, 10 is High
Why did you choose that rating?
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What has stopped you from achieving your goals in the past?
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What does a typical day of eating and movement look like right now?
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Lifestyle & Environment
What are your biggest challenges staying consistent?
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How is your current lifestyle affecting your energy, confidence, and relationships?
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Mindset & Identity
What limiting beliefs do you have about yourself or your ability to change?
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How committed are you to changing your life right now?
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Not committed
1
2
3
4
5
6
7
8
9
Fully committed
10
1 is Not committed, 10 is Fully committed
Are you ready to be held accountable and coached even when it gets uncomfortable?
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Yes
No
Habits & Discipline
What habits do you know you need to change immediately to get results?
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How do you currently handle stress, pressure, or setbacks?
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Investment & Seriousness
How much are you willing to invest in yourself in time, energy, and financially to achieve real, lasting results? 12 weeks upfront or weekly
$1,440 -$120
$1,680 - $140
$1,920-$160
Are you willing to follow structured nutrition, training, and mindset coaching consistently even when life gets busy?
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Yes
No
Please explain your answer above.
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What do you think will happen if you do not change anything in the next 6–12 months, and how will that impact your life?
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Outcome & Expectation
What would achieving this transformation mean for you as a man, father, and role model?
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What kind of coach do you need to get the best out of you? (e.g., strict, supportive, direct, motivating)
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Submit
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