You can always press Enter⏎ to continue
1:1 Online Personal Training Inquiry Form
1
Image Field
Previous
Next
Submit
Press
Enter
2
What is your full name?
*
This field is required.
Previous
Next
Submit
Press
Enter
3
What is your email address?
*
This field is required.
Previous
Next
Submit
Press
Enter
4
How old are you?
*
This field is required.
Previous
Next
Submit
Press
Enter
5
How tall are you? (inches)
Previous
Next
Submit
Press
Enter
6
Do you have any past or current health restrictions I should know about?
*
This field is required.
Previous
Next
Submit
Press
Enter
7
Are you on any medications currently?
*
This field is required.
Previous
Next
Submit
Press
Enter
8
What would be your goal for our 1:1 Online Personal Training?
Build Muscle/Mass
Lose Body Fat
Maintain
Other
Previous
Next
Submit
Press
Enter
9
What are your current eating habits?
*
This field is required.
I track my macros
Intuitive eater
Keto
I track nothing
Other
Previous
Next
Submit
Press
Enter
10
If you track your caloric intake, what are your macros/calories set at right now?
Previous
Next
Submit
Press
Enter
11
Have you ever had an online coach? If yes, describe the outcome of that experience.
*
This field is required.
Previous
Next
Submit
Press
Enter
12
Do you have access to a gym?
(with dumbbells, barbell/weights, cables etc?)
YES
NO
Previous
Next
Submit
Press
Enter
13
Are you really ready to commit to reaching your goals?
*
This field is required.
1
2
3
4
5
I guess so
FRICKEN, YES!
Previous
Next
Submit
Press
Enter
14
Are you willing to invest in yourself and commit to 3 months with me?
*
This field is required.
YES - I am willing to invest
I can't afford to invest in myself right now
Other
Previous
Next
Submit
Press
Enter
15
If we feel like it's a great fit and want to move forward, and I told you investing for a month was $400.00 (this is not the actual cost) what would your response be?
*
This field is required.
SIGN ME UP! I can pay in full.
SIGN ME UP! I need a payment plan.
I am not ready to invest in my life and my health & fitness.
Previous
Next
Submit
Press
Enter
16
Tell me a BIG LIFE GOAL of yours, and something FUN about yourself!
*
This field is required.
Previous
Next
Submit
Press
Enter
17
Image Field
Thank you so much for your Inquiry! Please allow 24hrs for a response via email!
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
17
See All
Go Back
Submit