Physiqonomics Coaching Application.
Please answer all questions in as much detail as possible and then hit the blue "Submit" button. I'll get back to you within 2-3 working days.

** These questions are for my purposes only and your answers will never be shared.**
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About you
First name *
Last name *
Email *
Please double check this is correct because I'll be reaching out via email.
Where do you live? (city/country) *
Gender *
Age (NOTE: my 1:1 program is only for people over the age of 25) *
What's your occupation? *
Just trying to get a gauge of how sedentary or active you are; if you control your schedule; if it’s a high-stress job, etc. as these things will change how I program for you.
Your current stats
Weight (Pounds) *
Height (feet and inches) *
What's your current body fat% (an estimate is cool)
What type of coaching are you looking for? *
Goals
What's your main goal? *
What would you like to achieve by working with me?
What's your biggest struggle when it comes to achieving this goal? (Said another way: what's preventing you from already having achieved your goal?) *
What's motivated you to make this change now? *
Why do you think I, specifically, can help you achieve your goal? *
Past experience
Have you worked with an online coach before? *
IF YOU ANSWERED "NO" TO THE ABOVE: Have you used a program in the past to help you achieve your goal?
Clear selection
If you've used a program – what program did you use?
Current Training
Are you currently training consistently? *
What does your training currently consist of? *
Weight lifting, crossfit, running, etc.
Nutrition/diet stuff
Do you have any nutritional preferences? *
Basically do you only eat paleo, low carb, keto, the hearts of your enemy. I need to know this.
Do you currently track your calories and macros? *
If you answered "No" to the above, are you willing to track your calories and macros?
I only work with people who will track their food intake. If you aren't willing to do this then we're not a good fit and I suggest working with someone else.
Clear selection
Health/injury history
Any injuries or health concerns I should know about? *
Misc.
Are you 100% committed and serious about achieving your fitness goals or are you simply trying to throw money at your problems? *
Coaching isn't magic and won't work unless you do -- so if you can't completely commit to this yet, then I suggest applying once you can give it your all
If you were referred to coaching by an existing client, what's their name?
Lastly, where did you hear about Physiqonomics? *
Submit
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