Client Intake Form for 1:1 Coaching

  • New Client Intake Form

  • Format: (000) 000-0000.
  • Gender*
  • Do You Currently Follow a Nutrition Plan?*
  • How Would You Rate Your Nutrition Consistency?*
  • How Would You Rate Your Training Consistency?*
  • Training Experience Level*
  • What Is Your Biggest Challenge Right Now?*
  • What Are Your Fitness Goals?*
  • Which division are you?*
  • Upload Front Photo
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  • Upload Back Photo
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  • Which coaching service are you interested in?*

  • Commitment

  • Are you prepared to follow a structured plan?*
  • Are you ready to invest in your goals and personal development?*
  • How committed are you to following your nutrition, training and cardio plan?*
  • Are you prepared to make lifestyle adjustments necessary to reach your goals?*

  • Thank you for your interest in Haley's Haus of Physiques. We will review your application and contact you within 24-48 hours regarding next steps.

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