Brentwood Barbell Coaching Application

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We help people accomplish their goals.

Please take a few minutes to help us better understand how we can help you achieve your goals. We look forward to learning more about you!

Full Name *

Age *

Sex *

Female

Male

Prefer not to say

Height *

Current Weight *

Phone Number *

Email *

How did you hear about us? *

Referral from friend

Google (or internet search)

Social Media

Other

If you were referred by a friend, we'd love to know who sent you!

Describe how active you are each day (this does not include training). *

Very light (sitting most of the day, example desk job)

Mixture (some standing, sitting, example teaching)

Moderate (continuous movement, example restaraunt server)

Heavy (strenous activity throughout the day, example construction worker)

How many days per week do you currently exercise? *

How long do your workouts usually last (minutes) *

Assuming you are working out, what exercises do your sessions typically consist of? *

What do you enjoy most about your current exercise program? *

What is your preferred eating style? *

Balanced (no major restrictions, will eat pretty much anything)

Mediterranean (emphasizes plants, healthy fats, and lean proteins)

Paleo (emphasizes meats, heatlhy fats, and vegetables)

Vegetarian (plant-based diet with small amounts of dairy and eggs)

Fully Plant-Based (no animal products of any kind)

Ketogenic (emphasizes high-fat, low-carb)

I have no idea, never thought about this. Not even sure what some of these are.

Required

Macronutrient Preference (this question examines your preferred nutrient intake regarding the big 3, carbs, fats, and protein). *

Balanced (a nearly equal representation of all macros in your diet)

Low Fat (emphasizes higher protein, carb intake)

Low Carb (emphasizes higher protein, fat intake)

I have no idea or no specific "diet" at this time

How many times do you prefer to eat per day? *

1 meal

2 meals

3 meals

4 meals

5 meals

6 meals

I have no idea, never kept track of this

Please list any supplements you are currently taking. *

Please list any medical / orthopedic information that would be relevant to your training. If you're not sure whether or not it's relevant, go ahead and list it so we can discuss. *

Are you currently seeking treatment with any health professional for the information listed above? If so, please explain. *

Please list any medications you are currently taking. *

Please describe your goal(s). Check all that apply. *

Increase Strength

Increase Muscle Mass (gain muscular bodyweight)

Athletic Performance (football, baseball, Olympic WL, Powerlifting, etc.)

Fat Loss (lose more than 15 lbs. of body fat)

Body Recomposition (lose less than 15 lbs. of body fat)

Health (building non-specific healthy habits such as lifting, aerobic, and nutrition)

Rehab (to reduce pain / improve function)

Required

What are some potential barriers to you achieving your goal(s)? *

Have you worked with a coach before? If you have, please elaborate on the experience. If you have not, that's okay too! *

Have you ever competed before (examples include powerlifting, weightlifting, marathon, 5K, CrossFit competition, HS or collegiate athlete, etc.)? We'd love to hear more about it if you have. *

How many days per week would you like to train with us? *

Our core services include Strength and Nutrition Coaching. We offer these services in private, group, and remote settings. Please tell us which of these services seem to be the most appealing to you. You're not making any commitments here. *

Private Strength Coaching

Group Strength Coaching

Remote Strength Coaching

Nutrition Coaching

Required

Improvements in health related outcomes such as optimal body composition, blood pressure, lean mass, bone density, and metabolic health all have an established dose-dependent relationship with strength training, aerobic training, and healthy nutrition habits. Please rate your "readiness for change" regarding exercise and nutrition. *

I want to change my exercise/nutrition habits but I'm not sure where to get started.

I want to change my exercise/nutrition habits but I struggle with being consistent or maintaining motivation.

I am all in, no issues with changing habits or being consistent

What time would be best for us to have a conversation regarding your application for coaching? Our meeting will last about 45 minutes. We're happy to talk over the phone or have you come in and see the gym! *

Tuesdays, 7 am

Wednesdays, 6pm

Thursdays, 12pm

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