Fitness Coaching Application
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Phone Number
Your Preferred Communication Method
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Resting Heart Rate
Blood Pressure
Approximate Body Fat Percentage
How did you hear about my coaching program?
Can you briefly describe your specific, short-terms goals (with the next 12 weeks)?
Can you briefly describe your long-term goals (over the next year)?
Do you have any specific injuries or medical conditions that you’re dealing with?  If so please detail below:
Are you training consistently?
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How would you rate your current level of fitness?
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Briefly describe your current strength training routine.
Briefly describe your current cardio routine.
Do you have any Martial Arts, Boxing, or Kickboxing experience? Would you be interested in making it a part of your fitness program?
What type of fitness equipment do you have access to? Please list below:
Any Favorite Exercises?
Any Exercises You Want to Avoid?
Are you willing to invest $200 to $600 per month into improving your health and fitness?
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On a scale of 1 to 10, how committed are you to following through on your fitness program?
Commitment issues
Maximum Effort
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