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Fat Loss Programme Application
Hi,
Thank you for your interest in my fitness coaching.
Please fill this form out and you will receive an email to book a consultation call with me.
Have lovely day!
Beth
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Email
*
Your email
First and last name
*
Your answer
Phone number
Your answer
Are you interested in the membership or just PT sessions?
Membership
PT sessions
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Instagram handle or Facebook name
Your answer
On a scale of 1 - 5, how happy are you with your current physique, strength and fitness?
(extremely unhappy)
1
2
3
4
5
(extremely happy)
Clear selection
How would you rate your knowledge of health and fitness? 1 very little - 5 more than the average person.
1
2
3
4
5
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What is the ultimate goal you would like to achieve by working one to one with me?
*
Lose weight
Build muscles
Get fitter
Stay consistent with exercise
Stay consistent with your nutrition
Other:
Required
Please describe your typical day
At the office
Mostly at home
Physical work
Long daily walks
Other:
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How often do you exercise for more than 30 minutes (this does not include walking)?
Almost every day
Several times per week
Several times per month
Once in a while
Never
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How often do you walk for more than 20 minutes at a time?
Every day
3 - 4 times a week
1 - 2 times a week
A couple of times a month
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How many times per week would you like to work out?
1 - 2 times
3 - 4 times
5 + times
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How much time do you want to spend working out?
15 - 30 minutes
30 - 45 minutes
45 - 60 minutes
I don't know
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What time of day do you want to workout?
Your answer
What kind of exercise do you prefer?
Resistance training
Body weight
HIIT (high intensity interval training) or circuit training
Aerobics
Running
Walking
Cycling
Which areas of your body do you want to strengthen most?
*
Belly
Butt
Legs
Arms and shoulders
Back
Required
What level of intensity do you want from a fitness coach?
Not intense
A little intense
Sometimes intense
Intense
Extremely intense
How would you describe your ideal fitness coach?
High energy
Knows when to give me tough love
Calm, cool and collected
Always positive
Other:
Tell me about your health and fitness journey, what have you struggled with the most? E.g. sticking to an exercise routine, being consistent, all or nothing behaviour (going all out for a week or two and then stopping).
Your answer
Do you have any health issues/conditions/physical ailments that could prevent you from performing intensive exercises such as HIIT or resistance training?
*
Your answer
What is your height?
Your answer
What is your weight in KG?
Your answer
Are you ready to commit to putting in the work and showing up consistently for yourself?
Heck yes!
I'm nervous...but yes!
I'm not sure yet and would like to learn more.
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Do you understand that my role as your trainer is to provide you with the training, knowledge and accountability to reach your goals, however, it requires hard work and commitment from you to follow your programme and nutrition goals?
Yes
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How would you like me to contact you?
*
Whats App message
Email
Are you aware that my fat loss programme costs from £60 - £145 GBP per month paid electronically for a minimum commitment of 12 weeks?
Yes
Clear selection
Are you aware my PT sessions are £40 an hour?
Yes
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A copy of your responses will be emailed to the address you provided.
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