Client Application Form

Helping you say goodbye to endless dieting & build your most confident body!

Interested in Training & Nutrition Coaching? Please tell me about yourself by completing this quick questionnaire. If we are a good fit for one another, I will contact you via email to go over the next steps in enrollment. When it comes to achieving your goals, there is no one-size-fits-all solution. That's why I offer a variety of coaching options, each tailored to your specific needs and goals. Together, we will determine the coaching option that is most suitable for you.

Name

First Name

Last Name

Phone

(###)

###

####

Age

Height

Current Weight

What is your main fitness and health goal(s) that you wish to accomplish over the next 12 weeks?

Ex. How do you want to feel, what do you want to look like, what state would you like to be in physically/mentally?

What do you struggle with when it comes to reaching this goal?

Do you know how many calories/macros you eat daily?

(If not, don't worry! We can go over this together!)

What does a typical Full Day of Eating looks like for you?

(Breakfast/Lunch/Dinner/Snacks)

What does your current fitness regime look like?

If accepted into the Fitness & Nutrition Program are you willing to commit yourself entirely to your goals mentally/physically/financially, and make yourself proud during our time together?

Yes! I've been looking for something like this!

I hope so.. I tend to struggle with motivation.

Is there anything else you would like to share with me at this time?