Let's get to know you
Email *
Full Name *
Phone number *
Date of Birth *
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DD
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YYYY
What is your preferred method of communication? *
Do you have any previous medical conditions that would prevent you for participating in our program *
if Yes please explain
Can I ask what it is you have struggled with and what you are working towards but now could do with just a little bit of help with?
What is your main motivator?
Why now?
How do you prefer to be motivated? *
Do you suffer with fatigue ? *
How would you rate your current Mental Health *
Not great
Top of my game
Do you suffer with Anxiety? *
Are you currently exercising? *
If answered yes to the previous question, what does your current exercise routine look like?
What are your goals? *
Required
Rate your current physical condition *
Current weight? *
Weight 2 years ago? *
How often do you eat fast food? *
How often do you drink Alcohol? *
How often do you miss breakfast? *
On Average how much sleep do you get each night? *
What are your 6 month goals? *
The challenge sessions run by Zoom @ 6 pm Tuesday and 10 am Saturday, can you commit to these times? *
Required
If you answered no to the above what times would work for you?
Are you happy to confirm there is no reason why you cant exercise in a safe and controlled environment *
Do you feel you would be a suitable client for Online Coaching and if so why? *
Do you understand that this will require a high level of commitment from yourself? *
If you had to put a price on you achieving what you have mentioned how much money are you willing to invest to finally move things forward? * *
Provided you are a good fit would you be happy to get started within the next week? *
Concept Fitness strongly recommends that you consult with your doctor before beginning any exercise program. You should be in good physical condition and be able to participate in the exercise. Concept Fitness is not a licensed medical care provider and represents that it has no expertise in diagnosing, examining, or treating medical conditions of any kind, or in determining the effect of any specific exercise on a medical condition. You should understand that when participating in any exercise or exercise program, there is the possibility of physical injury.If you engage in this exercise or exercise program, you agree that you do so at your own risk, are voluntarily participating in these activities, assume all risk of injury to yourself, and agree to release and discharge Concept Fitness from any and all claims or causes of action, known or unknown, arising out of Concept Fitness' negligence. *
When would be the best time to get in touch to arrange your 1 Week FREE Trial? *
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