ONLINE Coaching: Client Intake Form
This will help me decide if you are a good fit for an Online Coaching Client...
What is your current level of physical activity on a weekly basis?
Please describe your frequency, duration, type of exercise. Are you consistent, or do you tend to be more sporadic?
Your answer
What programs do you currently own and have used? *
Please select all programs that apply.
Required
Do you have any injuries that you are working through?
Check any areas that hold you back in workouts.
What is your motivation level for adhering to a prescribed fitness program?
Be honest.
Do you have any special conditions or take any medications that would impact your exercise program?
In your own words, describe why you are choosing to get online coaching. What do you hope to achieve? How will you know that you are successful? Do you plan to make this a lifestyle? Do you plan to follow up after your first package?
Your answer
What is the main thing preventing you from maximizing results on your own?
Please confirm that you understand the following by writing yes I confirm in box below:
As an online client, you will get three 30 minute skype sessions, a personalized program for 4 or 6 weeks, Weekly Check In Emails from Me and Weekly video tutorial reviews (5 minute video max per week). If you do not use your skype sessions, take advantage of the weekly sessions, or fail to respond to email during your package you will not be eligible for a refund.
Your answer
What is your Monday-Friday Schedule from wake to sleep?
Hour by hour, including meals. When do you plan to do your workout? AM/PM or both?
Your answer
What is your Weekend Schedule from wake to sleep?
Hour by hour, including meals. When do you plan to do your workout? AM/PM or both?
Your answer
What programs do you want to focus on in each week? Choose up to four.
What context to you intend to use this coaching for?
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