Consultation Form
Online Coaching Consultation Form – Coach Charlie Dimmock
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Email *
Name *
Address *
Phone number *
Instagram Handle *
Date of Birth *
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How long have you been training? *
Are you currently following a program? If yes, describe it briefly. *
What is your experience level with the following lifts? *
Squat, Bench, Deadlift.
What are your current best lifts (even if estimated)? *
How many days a week can you realistically train? *
List any injuries or limitations I should know about. *
What are your primary goals right now? *
Required
Are you planning to compete in a powerlifting meet in the next 6 months? *
If yes, do you need help with comp day programming, water cut, or gut cut?
What has worked for you in the past? What hasn’t? *
Are you currently tracking your calories/macros? *
Would you like help with nutrition and macros as part of your coaching? *
Do you have any dietary restrictions or preferences? *
How would you rate your current sleep and recovery? *
How do you prefer to communicate with your coach? *
Do you want weekly check-in video calls? *
Is there anything else you’d like me to know?
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