Online coaching application
Name
First Name
Last Name
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Email
example@example.com
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Mobile number
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Country Code
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Area Code
Phone Number
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Instagram handle
example@example.com
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Gender
Male
Female
Other
Prefer not to say
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Age
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Height (cm)
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Weight (kg)
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Average daily steps?
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Current occupation?
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How did you hear about me?
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Please give me some more information about your current lifestyle, how many days you exercise per week? What type of exercise do you perform?
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What does a normal day of eating look like for you? Do you track calories? How is your relationship with food?
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What would suit you better?
Fixed meal plan
Flexible macros (calories, carbs, fats and protein goal)
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Main goal
Fat loss
Muscle gain
Photoshoot
Maintain weight
Healthier lifestyle
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What foods do you NOT want on your meal plan?
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Do you have any dietary requirements or allergies? If so, what?
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Do you have any medical conditions?
Yes
No
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If yes, please provide details below.
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Have you ever worked with a PT or online coach before?
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If yes, please give a brief run down of your experience - good or bad (no need to name).
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What are your overall goals? Please share short term goal and a long term goal:
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What is preventing you from achieving these goals?
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What gym do you currently train at?
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How many days per week can you commit to exercise?
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What sort of workout plan have you been following if you have been following any?
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Are you ready for me to help you become the best version of yourself?
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What Monday would you like to start?
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Month
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Day
Year
Date
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Do you have any questions for me? Or is there anything else you would like me to know before arranging a consultation call?
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Are you willing to commit for 12 weeks to see serious results?
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