Client Application Form
Email address *
First and Last Name *
Gender *
Date of Birth & Age *
Phone Number *
Email *
Height *
Weight *
Estimated Percentage of Body Fat (if you don't know just put "unknown') *
Fitness Goals (list three) *
What's your biggest challenge(s) right now? In other words, what do you think is keeping you from reaching your goals? *
Do you have any injuries or other concerns that I should be aware of? (please list) *
How did you hear about me? (just curious) *
Do you play any recreational sports? *
How would you rate your current physical condition? *
Do you have a dietary preference? *
What are some of your favorite foods? *
Do you have any favorite exercises? *
Which one of my premium coaching program are you interested in? *
Why do you want to be part of my premium online coaching program?
Are you willing to commit to a 12 Week Program? *
If we were to work together, where would you be training? *
On a scale of 1-10, how committed are you to achieving your health and fitness goals? *
I love lying on my couch :)
I would run through a wall
Is there anybody else who may be involved in your decision to hire me as your coach or stick to a fitness program? *
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