THE 'FIT IN 21 DAYS' CHALLENGE Application Questionnaire
Please fill out the below questions in as much details as possible so I learn more about your current situation and goals, and to see if my program and coaching is a good fit for you.
Email address *
First and last name *
Your answer
Mobile phone number (so i can contact you if you qualify for this program) *
Your answer
Current weight: *
Your answer
Please tell me a little about your fitness and body transformation goals (including specific goal and ideal time frame of reaching this) *
Your answer
Why is this your goal.. what's the real reason for wanting to achieve this change..?
Your answer
What is your preferred type of workout? ie. Cardio, Weights, PT, Bootcamp, Boxing etc *
Your answer
Do you have any injuries, or illnesses I should know about?
Your answer
NUTRITION:
Please tell me a bit about what you're currently eating and drinking...
Typical breakfast
Your answer
Typical lunch
Your answer
Typical dinner
Your answer
How much alcohol do you drink a week, and what types?
Your answer
Any food allergies or particularly dislikes?
Your answer
MINDSET
Scale 1-10, how confident do you feel about your body, and fitness? and why?
Your answer
How would you reward yourself after achieving your goals?
Your answer
Are you 100% committed to getting results? *
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This form was created inside of Square One Fitness.