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- Date of Birth*
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Format: (000) 000-0000.
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- How would you prefer I contact you?
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- How would you describe your current activity level?*
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- What would you like to work on?*
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- How confident do you currently feel exercising on your own?*
- What kind of coaching support would be most helpful to you?
- How are you feeling about getting started?
- What might make it difficult for you to stay consistent?
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- How would you describe your overall health right now?*
- Have you ever been diagnosed with, or are you currently being treated for, any of the following health conditions?
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- Are there any current recovery or wellness concerns that may affect your ability to exercise or make healthy changes?
- Are you currently pregnant, recently postpartum, or planning a pregnancy?
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Format: (000) 000-0000.
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- Date of Acknowledgment*
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- How confident do you currently feel exercising on your own?*
- What equipment or training resources do you currently have access to?
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- What training preferences would help make your program enjoyable and sustainable?
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- What might make it difficult for you to stay consistent with exercise?
- What training environment would you feel most comfortable with?
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- How would you describe your caffeine intake?
- How would you describe your current alcohol intake?
- How would you describe your access to and comfort with preparing food?
- How would you describe your access to the foods you need or prefer?
- How confident do you feel making nutrition choices that support your goals?
- Do you follow any particular dietary preferences or have any foods you avoid or strongly dislike?
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- What are some of the biggest challenges you experience with nutrition or eating habits?
- How would you describe your grocery shopping and meal-planning habits?
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- What would you most like to improve about your nutrition?
- Have you tried any specific diets, eating plans, or nutrition approaches in the past?
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- What other areas would you like coaching to support?
- What would you like your coaching experience to feel like?
- Would you like faith to be incorporated into your coaching experience? If not, I am still absolutely happy and welcome everyone, no matter the faith!
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- Which areas would you most like to focus on?
- Which services are you interested in receiving?
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- Date of Acknowledgment*
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