Alissa Oddo Online Coaching Application

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For your plan to be as best of a fit to you, be as specific as possible. Your answers will provide me with information to create the best possible plan for you. Once you finish filling out the form, I will contact you to schedule a 30 min consultation to discuss your plan and prices.

Email *

Client:

State Full Name

Today's Date of Application:
*

YYYY

Gender

Male

Female

Prefer not to say

Clear selection

Age

Height (ft & in)

Weight (lbs)

Instagram Handle (will contact you to setup consultation) *

What is your goal? (lose weight, gain muscle, get toned etc.) *

What is your occupation? (Better understand your daily activity level) *

Please list any physical activity that you participate in outside of the gym and work

Limitations or Health Concerns that may affect your training or nutrition. (Dietary restrictions, Gym access, etc)

If you have any injuries or past surgeries, please list them

Are you experiencing any stresses or motivational problems?

Yes

Clear selection

Please rate your readiness for change *

What following goals best fit with your goals? *

Improved Health

Tone Up

Increased Strength

Increased Muscle Mass

Fat Loss

Weight Gain

Build Gym Confidence

Excel in your sport

Required

Number of years training *

Less than 1 year

2-3

3-5

Do you currently have gym access and if not what equipment do you have available? Be specific.

Have you worked with another coach in the past? If so who and why did you stop? *

Are you willing to commit and invest into yourself for 3 months of training, dieting, and tracking in order to reach your results? *

yes (I'm serious about this and ready to invest in myself to reach my goals!)

no (I'm unsure and don't have the finances to invest in my goals)

what's your instagram for me to contact you (if selected) to schedule your meeting with my management department? (please be aware all consultation if chosen will be with my management team due to high volume of request and if selected, you'll then have a follow up call with myself as I'm going to be your personal coach for the next 3 months onwards)
*

How did you hear about me?

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