Application

Name *

First

Last

Sex *

Female
Male
Prefer not to say

Email *

Phone *

List two activities you enjoy: one that gets you active and one that you like for relaxation. *

In 3 sentences or less, what is your primary long term goal? *

What is your reason or motivation for achieving this goal? *

Why is this goal important to you?

What area do you struggle with MOST? *

Nutrition
Training and Exercise
Mindset and Motivation
Other

Other: Please Specify

What do you think is the biggest barrier standing in the way of achieving your goal(s)? *

On a scale of 1 to 10, how motivated are you to achieve this goal? *

1: Honestly, this goal isn't that important to me. (I’ll be on the couch if you need me.)
10: This goal means everything to me. (I’m putting on my good sports bra right now. Let’s do this.)

What have you tried in the past that has NOT worked for you? *

Failures are all learning experiences. It's helpful to know what you've tried and failed with in the past.

What have you tried in the past that HAS worked for you? *

List anything that has worked at least a little bit or that has worked in the past (even if it's not working right now).

Please rate your experience with strength training: *

What is a dumbbell? (I’m a total newbie!)
I’ve been in a gym a few times and I know my way around a squat rack (Intermediate)
I could teach a class on strength training at the local gym (Experienced)

Please rate your current fitness level: *

Total couch potato (but I’m working on it!)
I get moving occasionally, but not as often as I’d like
I could give Wonder Woman a run for her money in an arm wrestling competition

Have you ever worked with an online health coach, personal trainer, or nutrition coach before?

If yes, please specify

Why do you think my coaching can help you achieve your goal(s)?

How much are you willing to invest monthly to reach your goal? *

$200-350
$351-600
$601 -$1000+
Whatever it takes

Is there anyone else involved in the decision-making process for hiring a coach or your decision to stick with a fitness program?

Last chance! Is there anything else that I should know about you? *

Please take a minute to complete these three quick steps.

Step 1

Step 2

Step 3