Apply for a FREE Consultation
If you would like to become one of our Customized Program Clients with an online fitness training program specific to your needs please complete this application. This will give us a broad idea of your history for when we have our consultation call.

The data on this form will be collected and only accessible to you (the client) and myself.
Email address *
Full Name *
Your answer
Age *
Your answer
Height (feet and inches) *
Your answer
Weight (pounds) *
Your answer
Gender *
Occupation *
Your answer
How many hours do you work a week? *
Your answer
One a scale of 1-10 how happy are you with your physique right now? *
Not happy at all
Very happy
What is your #1 training goal? What are you looking to achieve with my help? *
Your answer
Please describe your existing and past dietary history. *
Your answer
Have you tracked macros/calories before? *
Do you have any conditions, injuries, or mobility issues that limit your ability to exercise? *
Your answer
How would you rate your level of exercise experience? *
How long have you been training? *
Describe your current training regimen with as much detail as possible please. *
Your answer
How many days per week can you dedicate to exercising? *
Your answer
Will there be anyone else (family member, spouse, etc.) involved in the decision making process for starting a fitness program? *
Your answer
Are you 100% dedicated to this process? *
Your answer
Phone number *
Your answer
What is the best time to call if needed? *
Your answer
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