2 Minute Online Coaching Application
Name
Your answer
Gender
Height
Your answer
Weight
Your answer
Email Address
Your answer
Occupation
Your answer
How Many Hours Do You Work Per Week?
Your answer
Waist Measurement (at naval)
Your answer
Are You Medically Cleared For Exercise?
Age
Your answer
Do you have any medical issues or physical limitations we should know about?
Your answer
Do you take any supplements or medications? If so, describe your current supplement/med regimen.
Your answer
Training History
Your answer
Are You Currently Exercising Regularly?
If Yes, Describe Your Current Training Program
Your answer
What kind of facility do you have access to?
What Are Your Primary Goals?
Briefly Describe Your Goals In Detail
Your answer
In terms of fitness, what's your biggest struggle(s) that you think I can help you with?
Your answer
How would you rate your ability to perform the following exercises
check the box that best corresponds with your ability
Advanced
Intermediate
Novice
Unfamiliar
Barbell Back Squat
Barbell Front Squat
Barbell Bench Press
Barbell Deadlift
Bent-Over Row
Barbell Shoulder Press
Pull-Up
List any exercises I should avoid in the designing of your program
Your answer
How many days per week would you like to train?
Your answer
Current Diet Plan
Your answer
Are You Familiar With Counting Calories or Macronutrients?
Are you willing to keep a detailed nutrition log with food consumption, exercise, and weight?
How did you hear about our coaching program?
Your answer
Any Questions, Concerns, or Comments?
Anything at all you would like to share.
Your answer
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