Clone of Online Coaching Consult Form

1

Full Name * This field is required.

First Name

Last Name

2

Phone number* This field is required.

3

Email* This field is required.

example@example.com

4

Postcode * This field is required.

5

Your age* This field is required.

6

Instagram Handle * This field is required.

7

How did you hear about Project Ascension?* This field is required.

8

Current Weight (kgs) & Height (cm)* This field is required.

9

Occupation* This field is required.

10

Daily Activity Level:* This field is required.

Sedentary- Desk job, no exercise

Desk job- lightly active a few times a week

Desk job- moderate exercise 3-5 times per week

Desk job- extremely active 5-7 times per week

Active job- no additional exercise

Active job- additional light activity a few time per week

Active job- additional moderate exercise 3-5 times per week

Highly active- active job with additional intense exercise 5-7 times per week

11

Where would you rate your current fitness level?* This field is required.

Beginner 0-1 years experience

Intermediate 2-3 years experience

Advanced 3-5+ years experience

12

What is your current training history? Are you currently exercising? If so, Please specify what you currently do and how many times per week* This field is required.

How many years, frequency, type of training- please go into detail.

13

do you track your steps?* This field is required.

yes

no

I have in the past

14

If yes, what is your current average weekly step count?* This field is required.

15

Do you have experience with tracking your food?* This field is required.

I've never tracked my food before

I have a rough idea but struggle to understand

I have a good understanding but don't currently track

I am currently tracking and have experience in doing so

I prefer not to track my food

16

Do you have any medical conditions/ injuries?* This field is required.

17

What are you looking to achieve out of working together? * This field is required.

Please be specific

18

Do you feel you are coachable? This refers to your openness towards listening, learning and doing your best to apply what is provided to you throughout your coaching journey.* This field is required.

YES!

I'm not sure

No, I don't think I am open to this

19

Why is achieving your goals important to you?* This field is required.

20

Book your consult call

21

If no time slots work, when is the best time to contact you to book in a time?* This field is required.

22

Please leave any other questions you may have for when we get in contact with you:* This field is required.

23

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