Request edit access
New Client Form
Filling out this form will automatically add you to my waiting list. If you have any questions I have a podcast linked below that explains everything...or you can always reach out via email or DM.

Keep in mind there is a 6 month minimum for coaching. You don't owe that $ all upfront but I just want us on the same page that this isn't some quick fix program :)

https://open.spotify.com/episode/0JEkvNdumOawWlXlUuPAmu?si=Y1KFBkWGRGSec0cyplKbeA

Thanks!

-JL
Sign in to Google to save your progress. Learn more
Email *
First and Last Name *
Sex *
Age *
Height *
Weight as of today
Average hours of sleep per night? *
Rate your sleep quality *
I sleep like sh*t
Out cold all night
What is your PRIMARY goal? *
What is your SECONDARY goal? *
What is LEAST important? *
What are your short term goals - What do you want to achieve in the next 4-6 weeks?
What are your long term goals? *
Roughly how many steps do you get daily? *
Are you currently training consistently? *
How many days per week do you currently train? *
How many days per week do you WANT to weight train? *
What is your ideal duration for a workout? *
Currently, what does your week of workouts look like (including any cardio you're currently doing)? *
If you have any diagnosed health problems, please list them here. *
If you are on any medications, please list them here. *
Do you currently have any injuries? *
Are you currently working right now? If so, what do you do for a work? *
What do your weekends look like? Netflix n chill? Out to eat with friends? Nightclubs till 6am!?! *
Describe your alcohol consumption. *
Amount, frequency, type of drinks you enjoy etc
Do you prepare the majority of your meals? *
How many meals do you typically eat each day? *
Are you currently following a specific diet or nutrition plan? *
If so, what is the name of your diet or could you please describe it for me.
What is your average daily caloric intake? (If you know) *
Have you ever counted calories/macros before? If so, what was your experience like? *
1-10 How would you rate your knowledge of nutrition *
I'm just good at eating
I count macros in my sleep
How's your relationship with the scale? Do you ever weigh yourself? *
Have you ever had another online coach? What were some likes/dislikes? How was that experience? *
Have you ever had an eating disorder or thought you may have an eating disorder? *
Do you have any food allergies? If so, what are they? *
Would you rather: *
Please elaborate on your answer: *
Favorite movie or book
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms