Coaching Services Application
**WAITLIST ONLY** Please complete the questionnaire below in order to apply for coaching services with Lacey. After receiving your application, you will be contacted once the client list is reopened to discuss next steps.
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First and Last Name *
Date Of Birth *
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Age *
Email Address *
Phone Number *
Time Zone *
Mailing Address (Street Address, City, ST, Zip Code) *
Height (ft) *
Weight (lbs) *
What is your Instagram username? Skip if not applicable.
Which is your preferred weekly check-in day? *
What are your fitness & health goals? Please be specific. *
What is Your Estimated Body Fat Percentage? (Use the provided image for reference, if needed) *
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Do you have access to a gym? *
Are you currently tracking your macros? *
If tracking macros, please provide your current macro goals. (Ex: 145g P / 185g C / 50g F)
How many days per week do you want to do strength training? *
Are you currently taking supplements? (Ex: Protein, Pre-Workout, Fat Burners, etc.) *
Which best represents you? *
Do you have any food allergies or nutrition concerns I should know about? *
Do you have any medical limitations or injuries that may prevent you from performing at a high level? If so, please explain. *
Are you currently on any medications? If so, please share what medication and dosage you're taking. *
Are you able to commit to a long-term investment for your health and fitness goals? Typically, those who can commit to 6 - 12 months will see the best results. *
Please select the coaching package you are most interested in. *
Shirt Size *
Are you available to start being coached by Lacey immediately? *
Please share any questions you have about this coaching opportunity.
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