Body Confident Fitness 1:1 Coaching Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please fill out the form below and I will contact you within 48 hours. Be advised I have a limited number of openings for Online Coaching.

Email *

Name *

Phone number

Zip Code *

How many days per week are you available to train? *

Monday

Tuesday

Wednesday

Thursday

Friday

Weekend Warrior

Required

Do you prefer to workout in the *

Early Morning (before 9am)

Midday (9am - 2pm)

Afternoon (2pm - 5pm)

Evening (after 5pm)

How many minutes do you have on average to workout per day? *

less than 15

15-30

30-60

more than 60

All workouts are designed for in home use, do you have space in your home or garage to workout? *

Yes

I'd prefer Gym workouts

Please tell me what your main health and fitness goal is? *

What do you want to accomplish by doing this program? *

Look good in special piece of clothing (ie. bathing suit, little black dress, wedding dress etc)

Be able to run after my children

Improve overall health (ie. lower blood pressure, lower cholesterol, reduce risk of diabetes)

Other:

Change takes time! Are you willing to commit to a 3 month - 12 month program to achieve these goals? *

Yes

Maybe

What equipment do you currently have on hand (check all that apply *

Yoga mat

dumbbells

resistance tubes

mini loop resistance band

swiss exercise ball

I don't have equipment but am willing to purchase whatever is necessary

Required

This program requires a serious financial investment in yourself. On a scale of 1-10 how motivated are you to accomplish these goals? *

I’m thinking about it

Nothing will stop me

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms