Fitness Questionnaire
All your information given is completely private!
Full Name *
Email Address *
Age *
Current Weight *
Height *
Where do you live? (town and/or state) *
Name of Occupation *
Levels of Activity at work (sitting, standing, etc.) *
Do you have the financial resources to commit on a high level to transform your fitness and health? *
Have you ever tracked your calorie intake before? *
What is your goal? (build muscle, lose weight, get healthier) *
What's holding you back from your goals? Why do you want to hire a coach? *
Are you ready to transform your body and commit to overall health? *
Why do you think you need a coach at this point in your journey? *
Do you workout at-home or at a gym? *
If you workout at home, list the equipment you have, if any.
What is your current fitness routine look like? *
Do you have any pain performing certain exercises? OR Do you have any past injuries that need attention?
Is there anything specific you want to work on?
How many times per week can you commit to working out? *
Is it hard for you to find motivation on your own? *
Do you want to work with me.... *
Did anyone refer you to me? Or Where did you find me? *
Any other info I need to know:
Thank you for taking the time to fill out this questionnaire!
If you have any other immediate concerns, please contact me at
Otherwise you will be contacted within 48-72 hours.
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