Pryme Image Coaching (PIC)

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Send in your application so we can try to solve your biggest fitness problem!

How did you find us?

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Instagram handle *

Name *

What’s your age? (Must be 18+ to apply) *

Phone # *

Are you located in the USA? *

Yes

State,City, Zip code *

Do you have any past or current injuries? If yes, please explain *

Do you have any medical conditions that will affect your training? If yes, please explain any information your doctor has said in regards to working out and diet *

Choose one that best describes your diet *

I know what goes in my body and track macros pretty consistently.

I wing it by eating what seems healthy as often as I can.

I’m currently just living life.

What does your current fitness routine consist of (days per week, body parts focused, hours it takes to complete ect) *

In a year from now, what's your dream body look like? (please be specific, such as weight, body fat percentage, etc *

How much progress towards your fitness goals did you make last month? *

What roadblocks are slowing you down from attaining your dream body? *

Do you have a personal trainer or are following a specific program you found/bought? If so, please tell us what the program is or what your trainer has you do. *

6. How is your fitness progress going? *

Poorly (zero to little progress)

Struggling (some progress, but not as fast as you like)

Successful (good progress, just looking to sustain it)

If you could begin making fast progress towards your fitness goals, would you be interested? *

Yes

Would obtaining your dream body improve your quality of life besides health? (Career Opportunities, Connections, Positive Attention, Confidence, Respect, Higher Quality Mates) *

Yes

Choose one that fits your current circumstance *

I’m so ready to sculpt the body I know I deserve and reap the rewards

It’s not that serious but it seems like a good idea.

What kind of help are you looking for right now? *

I want a DIY Solution ($) (Money’s very tight and I’d rather learn and do it by myself)

I want a Done with Me Solution ($$) (Do the work myself w/ specific coaching on what to fix)

I want a Hands On Solution ($$$) (Money's not an issue. Want 1 on 1 done with you coaching)

What’s your current occupation? *

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