Coach Louis' Nutrition Coaching Application
This form is to learn more about you, the potential client, and see if we best fit together. Please do not hold back any information I may need during this process.
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Email *
First Name *
Last Name *
Were you referred by a current client? If so, who?
Gender *
Birthday *
Age *
Height (in inches) *
Current Weight (in pounds [lbs]) *
Facebook Profile Link
Instagram Username
Is your *primary goal* fat loss? *
What kind of workouts/training do you do? (ie: bodybuilding style, powerlifting, Crossfit, OTF, etc). *
How active are you outside of the gym (1 sedentary -> 10 extremely active) *
Extremely Active
What exactly are you wanting to achieve with coaching from me? What are your goal(s) short term and long term? *
Have you ever worked with a personal trainer (either in person or online)? If yes, what was your experience? *
Do you have any health issues or past injuries we should know about, such as asthma, diabetes, back pain, etc, we should know about? If so, please explain here. *
Please list any medications you're taking. *
Are you pregnant or might be pregnant? *
Is there anything to prevent you from working out? If yes, explain. *
Are you already experienced w/ Flexible Dieting, IIFYM, tracking macros? *
Are you currently tracking your macros? If yes, what is the calories/macros intake? *
Have you had success or trouble following diets in past? *
Are you an emotional eater? *
Do you binge on food? What's the trigger(s)? *
How often do you consume alcohol? *
Do you smoke? *
Do you consider yourself motivated to reach your goal? *
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