ANKR Coaching Application
Take a couple minutes and to share your goals, current habits, and health history so we can see if 1-on-1 coaching is a fit.
Applicant Information
First Name
*
Last Name
*
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Instagram/Facebook Username
How did you hear about ANKR?
Please Select
Instagram
Facebook
Friend or Family
Referral
Search Engine
Event
Other
Occupation
Age
*
Current Weight
Height
Goals, Health, and Readiness
Primary goal
*
Please Select
Injury prevention/recovery
Faster/more explosive
Strength
Nutrition
Body composition
Mental toughness/consistency
Other
Current or recent injuries, pain, or mobility restrictions
Most important criteria for success
*
Is health valuable to you? Why?
*
What have you tried before, and why hasn't it worked or why do you need coaching now?
*
Readiness
*
1 = I’m fine where I am
1
2
3
4
5
6
7
8
9
10 = I’ll do whatever it takes to reach my goal
10
1 is 1 = I’m fine where I am, 10 is 10 = I’ll do whatever it takes to reach my goal
Are you ready right now to invest in yourself if this is a fit?
*
Yes
No
Are you willing to invest $100+ per month in yourself?
*
Yes
No
Lifestyle and Support
Average weekly spending on coffee or energy drinks
*
Please Select
$0 (N/A)
$1-$10
$11-$25
$26-$50
$51+
Average weekly spending on eating out
*
Please Select
$0
$1-$25
$26-$50
$51-$100
$101+
Average weekly spending on alcohol
*
Please Select
$0
$1-$25
$26-$50
$51-$100
$101+
Average weekly spending on smoking or vaping
*
Please Select
$0
$1-$25
$26-$50
$51-$100
$101+
Daily sitting/activity level
Mostly sitting (sedentary) 8h+
Some sitting, some movement
Mostly active
Does your spouse or partner support your decision to start coaching?
*
Yes
No
N/A / No partner
Coaching Fit and Motivation
What do you expect from your coach?
*
Why is 1-on-1 coaching with ANKR the right fit for you right now?
*
What would be good about making this change, and what could become possible?
*
What would be hard about making this change? What would you have to give up or what routines might be disrupted?
*
What could go wrong if you do not make a change?
*
If nothing changes, what do you think life will look like in 5–10 years physically, athletically, and mentally?
*
Commitment and Next Step
ANKR commitment statement
Are you ready to move forward if this is a fit?
*
Yes let’s go!
How would you like to move forward after submitting this form?
*
Please Select
Personalized video consultation (I’ll record a walkthrough you can watch on your own time)
Live Google Meet call
Submit
Should be Empty: