J.Reich Training Personal Training and Online Training Application
Please fill out the application below. If we are a good fit, I will contact you within 48 hours to set up a phone consultation and discuss the next steps. Thank you, Justin Reich
Email address *
First and Last Name *
Your answer
Age *
Your answer
Gender *
Email *
Your answer
Phone *
Your answer
Height *
Your answer
Weight *
Your answer
What's your favorite book, podcast, tv show, or movie? *
Random question, I know. But, this helps me understand you a bit better.
Your answer
What's your favorite quote? *
Your answer
Tell me about your training history: *
Summarize your previous and current training history, how many times you workout per week, and form of exercise, if any (strength training, cardio, yoga, etc.)
Your answer
When was the last time you took a week-long break from you exercise routine *
Health history
If yes, please briefly describe below. If none, please reply "none"
Your answer
Are you taking any medication(s) *
If yes, please list below. If none, please list "none"
Your answer
Any injuries or limitations? *
If yes, please briefly describe below. If none, please reply "none"
Your answer
Any dietary limitations? *
Ex: Celiacs, gluten intolerances, lactose intolerance, etc. If none, please reply "none".
Your answer
On a scale from 1-10, rate your average level of energy throughout the day, "1" being a "Sloth on Zoloft" and "10" being a "Hummingbird on PCP" *
Sloth on Zoloft
Hummingbird on PCP
Briefly describe your 3-month goals: *
Your answer
In an ideal world, in three years what shape would you be in? *
Your answer
Do you consider yourself a high-achiever? Someone who aims for progress, is self-motivated, driven, and often self-reflects or seeks advice on how to improve "x"? *
What roadblocks or hurdles do foresee that could prevent you form reaching your goals? *
Your answer
Have you had a coach before? *
What do you think my coaching can help you achieve? *
Your answer
On a scale of 1-10, 1 being "I could care less" and 10 being "I'll do whatever the it takes", how committed are you to achieving your fitness goals? *
Mehh...I could care less.
Short of donating my left lung, I’ll do whatever it takes.
Are you willing to invest $300-$500 per month? *
Is there anybody else who may be involved in either your decision to hire a coach or you desire to stick with a fitness program? *
i.e. Spouse or partner
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