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Email *
What type of coaching are you applying for? *
Name *
Age *
Gender *
Weight in kg *
Talk to me about your goals… *
Have you attempted to reach these goals in the past?  If so what happened? *
How will you feel if you reach your goal? *
How will you feel if you do not reach your goal? *
Do you have a specific time frame in mind? *
On a scale of 1-10 how happy are you with your body right now? (1 Unhappy to 10 Perfection) *
What is the biggest problem I can help with at the moment? Please be specific *
Have you Tracked calories/ macros before? *
What does a typical day look like for you food wise? *
How do your weekends differ from this? *
Talk me through yesterday; from when you first got up, when did you first eat and drink? What did you have? *
Did you have anything with your tea/coffee? *
How long have you been training? *
What are you looking to achieve with me? (please be specific as possible) *
Injuries? *
Occupation? *
How many days a week are you looking to train? *
What equipment do you have access to? i.e Jump rope, Dumbbells etc *
What is your dieting history? (please include any info about eating disorders here) *
How was your experience on this diet? Did you find it challenging? *
Do you suffer from IBS. If so, what foods/environment trigger it? *
What does a typical week look like in terms of exercise? (please be as specific as possible) *
How do you feel the week before or week of your cycle (please be as detailed as possible)? *
Are you on the pill? (if so. please input which one) *
Are you taking supplements? (Please list) *
How would you describe your daily energy levels? *
Is there anything that you have found either positively or negatively effects energy levels? *
What is your sleep like? How many hours of sleep would you tend to get on average per night? *
What is your caffeine intake like? *
How driven are you to succeed (0-100%) *
Where did you hear about Shane Walsh Fitness? *
Phone number *
Best time to contact you *
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