Name
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First Name
Last Name
Email
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Phone
(###)
###
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Timezone
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Eastern Standard Time
Central Standard Time
Mountain Standard Time
Pacific Standard Time
Alaska Standard Time
Hawaii-Aleutian Standard Time
Other
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
How did you hear about us?
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What are your health and fitness goals?
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What do you wish to accomplish in terms of physique, mindset and nutrition?
I am interested in help with:
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Check all that apply
If other, explain below:
What is your number one struggle or biggest obstacle holding you back from achieving your goals?
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What methods have you tried in the past to reach your goals?
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On average, how many days are your currently exercising?
How many days could you commit to exercising?
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Do you have any previous injuries? If so, please describe
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Do you have a history of emotional eating?
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On a scale of 1-10, how serious are you about achieving your health and fitness goals?
Do you have experience tracking macros or calories?
Check all that apply
Please provide a REALISTIC full day of eating. Please be as descriptive as possible, including portion sizes, amount of meals, all snacks etc.
Honesty is best! This is a judgement free zone.
How many times do you dine out/order takeout, takeaway
When dining out, what are you go-to choices? Include restaurant type, appetizers, meal, drinks (alcoholic/non-alcoholic) dessert etc
Be as descriptive as possible!
Occupation
Do you drink alcohol?
Smoking status
What are your hobbies, passions, etc outside of health and fitness
Describe your short term goals:
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0-3 months
Describe your long-term goals:
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6-12 months and beyond
We are a fully customized company and pride ourselves in not providing cookie cutter style programming. We are hands on, 1:1 coaching specific to you and your goals. Why do you desire to work with us?
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What does your support system look like? Do they know you are interested in INVESTING in your health?
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If we are able to offer 100% customized programming, are you financially ready to commit and invest in yourself and your future?
Would you like your spouse/partner to participate in the call so you are able to make the decision together?
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Can we count on you to follow through with this application process?
Preferred method of contact to schedule a call
If you answered Facebook or Instagram DM, please provide link to profile below:
If referred by a friend, who?
To help us prepare for the call, please list any questions or concerns you may have.
No question is too silly, ask us anything!
