Coaching Application Form

Full Name

First NameLast Name

Gender

Date of Birth

MonthDayYear

Age

Years

Height

CM / Feet

Weight

KG/LB

Please list the physical activities that you participate in outside of the gym and outside of work:

If you workout what weight did you most recently lift and what are your best liftsfor different movements? e.g Squat, bench, deadlift, shoulder press.

How do you manage stress in your life?

I am interested in learning about managing my own training:

Please list all of your concerns about your health, fitness, nutrition, and/or body:

Out of all of the above, what feels most important/urgent?

Are you comfrotable with using google sheets?

Have you previously worked with a personal trainer or online health coach?

If you have previously worked with a trainer please briefly outline what worked well and what didn't go well?

Did you have an athletic childhood where you played competitive sports?

If you have any diagnosed health problems list the condition(s).

If you are taking any medications or supplements, please list them.

If you have had any major or chronic injuries or surgeries , please list them. e.g a broken bone when you were 5.

Do you suffer from diabetes, asthma, high or low blood pressure?

Are you a current cigarette smoker?

Do you drink?

How many times/month?

Please rate your motivational level to do what it takes to reach your goal.

What will a successful outcome look like for you? Please expand and detail, very important answer.

What type of coaching are you interested in?

How did find you Progression Health Coaching? (If referred by a person feel free to name them)

Where are you based? (If outside West Coast of US Pacific time zone) Please include timezone.

1.)WAIVERS

Must be signed and completed before commencement of coaching.

2.) VIDEO CALL CALL CANCELLATIONS / LATES

Cancellations should be made at least 24 hours in advance of a scheduled call when possible. Each call shall be up 30 minutes in length.

3.) COACH CLIENT CONTACT / INTERACTION

I will be available to reply to all emails and messages within 48hours (Usually 24hours) unless stated otherwise e.g if I'm traveling.

I will not check in with you outside our agreed calls however I advise and encourage that clients contact me about any training and nutrition-related questions they may have. If you want to learn and develop your own knowledge it is up to you to ask about what you are unsure of while also ensuring you get the most out of this service.

4.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT

All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given will be kept confidential.

I agree to the above terms and conditions:

Phone Number

Area CodePhone Number

Email

example@example.com

Appointment

Consultation Questionnaire

Lifestyle Information

Medical and health information

Goals

Please Read The Following Terms and Conditions.