Let's Work Together

Interested in coaching, a program, or learning more? Start here.

This form helps me understand what you’re looking for so I can point you in the right direction. Please allow 24–48 business hours for a response.

Email *
Full Name *
Phone Number *
Location (City & State) *
What is your date of birth? *
MM
/
DD
/
YYYY
What is relationship status?
What are you interested in learning more about?
 *
 How did you hear about me?
 *
What are your primary goals right now?
 *
What is your primary reason for wanting to accomplish the above goals? Tell me your WHY. *
What do you feel has been your biggest struggle?
 *
  Are you currently working with a coach or trainer?   *
Which best describes where you are right now? *
Are you open to investing in coaching or a structured program if it’s a good fit? *
Do you have any prior injuries or surgeries that prevent you from exercising or are inflammed by exercise OR have you had any weightloss or cosmetic surgeries? If yes, list them in the "Other" section. *
Required
Are you physically active now? If yes, please describe what type of activity you are involved in, the frquency, and duration. If NO, please tell us what is hindering you from being physically active *
Are you currently following any special diet or have dietary restrictions? If yes, please describe in the "other" section. *
Required
Are you currently taking any other medications, including Ozempic, Wegovy, etc? If yes list them in the "other" section
Clear selection
Do you have a gym membership
Clear selection
Use this space to communicate anything else you'd like, your trainer, to know about as it pertains to your goals, health or success in our program.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Not Your Average Trainer, LLC.

Does this form look suspicious? Report

Google Forms