Are You Ready for a Lasting Transformation?

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Application or Inquiry for Beyond Basics Fitness & Nutrition Training

First Name *

Last Name *

Age *

Gender *

Female

Male

What option best describes your current situation? *

I have a lot of weight to lose (50+ pounds)

I want to lose 20-40 pounds

I've lost weight but I'm stuck at those last 10-15 pounds

I'm OK with my weight but I would like to tone and build muscle

Other:

What is your current fitness level? *

Poor

Fair

Solid

Excellent!

What do you feel is your biggest obstacle to achieving your weight loss/dream body? *

Have you hired a fitness trainer or coach before? *

Yes

If you answered yes, please explain. (Short answer is fine.)

Do you have an illness, injury or anything else that could affect your training? *

Are you on any dietary restrictions, special diet or nutrition plan? *

Why did you choose to inquire about my training/coaching? *

What do you think my training specifically can help you achieve? *

How ready are you to make a lasting change to your physique and get in awesome shape? *

So Ready!

Sort of, Not Quite Ready

Not Ready. Procrastination Is My Middle Name

I'm Still On The Couch

Are you prepared to invest in your body, health and fitness? ($100-400/month) *

I'd do it if it got me the results, no question

A little hesitant, but open to investing to solve this problem

I'd rather not spend any more money and stay where I am

I'm inquiring about what type of training sessions? *

One-on-one in person training

Partner in person training

3-4 small group in person training

Online Training

Hybrid (combination of in person and online training)

If you are applying for partner training, are your and your partners' fitness levels and goals similar? *

Yes

N/A

If you are applying for in person partner or small group training, have you checked to make sure your schedules will mesh to train together consistently? *

Yes

N/A

Is there anyone else who may be involved in either your decision to hire a trainer or your desire to stick with a fitness program? *

Phone Number *

Note the best days and times for me to call to answer any questions you may have.

Best Email Address *

What is your favourite TV show, movie, book or podcast? :)

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