Contact Information
Let's get to know each other better and see if we're a good fit! Be as specific as possible!
Email *
Name *
Birthday *
MM
/
DD
/
YYYY
Contact Number *
City and State *
IG handle (i.e. @jill.e.fit)
What is your current fitness routine? (i.e. running, weightlifting, group exercise, etc *
What are your current eating habits? Is there anything you would like to change? Do you have any food restrictions and/or allergies? *
Do you have any medical conditions? Any physical limitations and/or restrictions? If yes to either, are you cleared by a medical professional to participate in an exercise program? *
What are your top 3 fitness goals? When do you want to accomplish these goals by? *
What has stopped you from achieving these goals? *
How important are these goals to you? *
not very important
extremely important
How committed are you to reaching your goals? *
it would be nice if it happened
let's do this!
Why do you want to work with me? How can I best help you achieve your goals? *
Is there anything else you'd like me to know about you?
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