Coaching Application Form
Please fill in the below questions the best you can, any further questions please contact me at roy.millward@gmail.com
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Full name *
Date of birth *
MM
/
DD
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Contact number *
Height *
Email address *
Weight (as you wake up first thing in the morning) *
What service are you interested in? *
Required
What's your current fitness level *
How many times a week do you currently train *
What time of the day do you prefer to train? *
Time
:
What kind of diet are you currently on if any? *
Do you do any cardio? If so describe below *
Please list any healthy foods you like *
Please list any healthy foods you don't like? *
Do you have any food allergies? If yes please list *
Any obstacles in your life currently effecting you reaching your goals
Do you have any medical conditions that I need to be aware of? If yes please list *
List any current medication you are taking including any PEDs *
Please list your short term & long term goals, for example Weight loss? Weight gain? Wellbeing? Confidence? Competing? *
Please let me know if you have any questions regarding the Coaching packages or PT sessions, also list any extra information I may need to know, for example vegan, vegetarian, pescatarian, health issues or restrictions
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