Work with me
Email address *
Name *
Age *
Gender
What are your pronouns?
Phone
Skype username
Hogwarts house?
Clear selection
What's your favorite book?
Have you worked with a coach before? *
If yes, how was your experience?
Have you worked with an online coach before? *
If yes, how was your experience?
Any injuries, health issues, or backfired jinxes I should know about? *
What is your goal? *
How long have you had this goal?
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Have you tried to achieve this goal in the past?
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If yes, were you successful?
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What methods have you tried in the past to achieve your goal?
How would you rate your current nutritional habits?
Poor
Fantastic
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Are you currently dieting?
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Do you have any dietary restrictions? *
Favorite foods?
Favorite wine/type of wine?
How would you rate your current relationship with food?
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Are you currently exercising?
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If yes, what types of exercise do you do? How often?
Do you follow a set program?
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Any favorite exercises?
If applicable, list your 1 rep maxes for squat, bench, and deadlift.
How is your energy?
I can barely keep my eyes open
My friends call me the Energizer bunny
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On average, how many hours of sleep do you get per night?
Is your sleep restful?
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How is your current stress level *
Luna Lovegood is my spirit animal. I take everything in stride
I make Anne Hathaway in The Devil Wears Prada look calm
How would you rate your self confidence? *
I'm pretty sure I was born without that one
I know I'm awesome and no one is raining on my parade
Briefly describe your goals for the next 3 months *
What would you like to accomplish by working with me?
Why did you choose specifically to apply to my coaching program? *
Why do you think that I can specifically help you achieve your goals?
When you picture your life a year from now, what does it look like? *
How does that image make you feel?
Clear selection
Are you willing to invest $300-600 per month on your health, fitness, and wellness? *
How committed are you to achieving your goals? *
About as willing as Professor Lockhart was to enter the Chamber of Secrets
As committed as Harry was to finding horcruxes
Is there anybody else who may be involved in either your decision to hire a coach or your desire to stick with a program? *
Who's your favorite superhero?
Anything else you would like me to know?
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