Sigs Fit Bits - Online Coaching Application Form

Coaching Application

Sigs Fit Bits
Full Name:

First NameLast Name
Birth Date:

MonthDayYear
Age:
E-mail:
Home Number:

Area CodePhone Number
Mobile Number:

Area CodePhone Number
Permanent Address:

Street Address

Street Address Line 2

CityState / Province

PostcodeCountry
Which Sigs Fit Bits program are you most interested in :
Current goals:
From the above list, which goal is currently most important to you? Short Term goals (0-6 months):
Discribe your long term goals (7-12 monnths:
Current Cardio Sessions:
Current Strength Sessions:
Please provide current nutrition regime (including Breakfast, Lunch, Dinner & Snacks:

How often have you purposely dieted for fat loss over the last 5 years?
Previous Dieting Methods:
What does your schedule look like (work, school, gym, etc):
Over the last 5 years have you had any injuries or surgeries?
Do you have any exercise limitations that I should be aware of?
Do you or any of your family deal with high blood pressure or diabetes?
Do you have any experience with calculating macro-nutrients or food tracking in general?
Is there anything else you feel I should know before we commence the coaching?
Please upload 2 photos (front & back) of yourself wearing clothes you feel comfortable in:

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