Individual Coaching Application

Hi, friend!

This application will help me understand what your goals are & how I can help you in reaching those goals.

Individual coaching is an in-depth client-coach relationship. If you are not looking for this level of guidance, I would direct you to other ways I can help you such as a Custom Nutrition Plan or a Train With Me membership.

Please elaborate as much as possible from the questions below. A big part in being able to help guide you, is to understand the "why" behind what you're needing help with, so I can determine how to help you. Context is EVERYTHING. Thoughts and situations that you might not think are related... most definitely are related. The more I know, the more I can help.

This is not a guarantee of services, but an application to give me an idea on what kind of support you're looking for.

I will respond within 24 hours to the email address provided with follow up questions, or a link to schedule your intake call (depending on Please allow extra time if you're filling this out on a weekend. Please check your spam folder if you don't see a response within that timeframe.

Coaching requires a 3 month initial comitment, as a trial period for both you & myself. That way, if either of us wish to end the relationship, we can do so without needing to fulfil a contract. Once the 3 month comitment is met, you are automatically moved to a month-to-month agreement until you tell me you've gotten what you need from our time together. You are also able to switch/remove services after the 3 month minimum agreement has been met (Ex: Keep Nutrition Coaching but remove Personal Training or vice versa).

1:1 Coaching is a comitment and will require a time & financial investment. The goal is that you gain knowledge and learn how to use tools so you can eventually continue what we've worked on together, on your own.

Name*

First NameLast Name

Email*

example@example.com

Age*

example@example.com

Gender*

MaleFemale

Which service(s) are you interested in?*

Personal TrainingNutrition CoachingBoth

What is your goal? (check all that apply)*

Describe the changes you'd like to see in your body. This can be during our time together, or in general. *

Physical changes, feel better, improve sleep, etc.

Did someone refer you to me? If so, what's their name?*

If no one referred you, just type n/a.

If interested in Personal Training, what type of workouts have you done in the past? Why are you not doing that now? What are you looking for in your future training program? How many days a week do you workout? Do you do cardio? Strength Training? A mix of cardio and weights? How long are your workouts? Do you do any other activity besides structured exercise (steps)?

Do you plan on working out at home or a gym?

HomeGymBoth

If working out at home, you will need basic equipment such as an adjustable bench, resistance bands, handles & door anchors, and weights ranging anywhere from 5-30#'s. I will provide affordable suggestions. Are you willing to invest in some equipment to do your workouts properly at home?

Yes will buyAlready haveNo

Please list any past or present physical injuries. What happened, what was the treatment, any current treatment?

If interested in Nutrition Coaching, what diets/approaches have you tried in the past? Why are you not doing that diet/approach anymore? Are you currently, or have you previously tracking calories/macros? Do you cook most meals? Eat most meals out? Do you meal prep? Do you meal plan? What does each meal typically look like?

Please list any past or present health issues you've experienced or have experienced? What was the treatment, any current treatment?

Blood pressure, diabetes, PCOS, IBS, food allergies, etc.

In the last 5 years, how much time have you spent "dieting" to lose weight?

What is/are your biggest obstacle(s) in getting where you want to be? (not knowing what to eat/how much to eat, consistency, food quality, education, etc.)

Have you previously, or are you currently, been diagnosed or dealing with an eating disorder?

YesNo

I need action from YOU to know which direction we need to go. This means, I need consistent, relevant, information such as weigh ins, measurements, pictures, food logs, completed workouts, and being willing to ask for help should you need anything outside of our checkins. Are you willing to help me help you by providing this information during our time together?*

YesNo

What are you ready to do?*

I'm ready - send me the contract & how to pay!I'd like to learn more via email

Individual Coaching Application

PERSONAL TRAINING QUESTIONS

NUTRITION COACHING QUESTIONS