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Coaching Consultation & Health Form
Be completely honest in your form as this is a relationship. I will help you get in the best physical & mental shape of your life. But we need to work together and I will provide you with a premium coaching service.
Once the form below is complete I will get to work on your plan. Then we can jump on a call in the next 24-48 hours to run over the program.
P.s. Check your junk and promotion section in your emails.
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* Indicates required question
Name:
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Your answer
Age:
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Your answer
Gender:
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Choose
Male
Female
Email :
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Your answer
Instagram name:
Your answer
Contact number:
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Your answer
Occupation:
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Your answer
Where do you live?
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Your answer
Please tell us about your current exercise/training programme, if any. For example, Push, Pull, Legs, CrossFit, Classes, Yoga, Running etc...
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Your answer
Goals?
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Choose
Fat Loss
Muscle Gain
Lifestyle Change
Why are these goals important to you?
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Your answer
Do you have any injuries?
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Your answer
Weight (kg/lbs)
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Your answer
Height (ft/cm)
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Your answer
What do you want from your Coach (Brandon Hepburn) Results, knowledge, confidence, lifestyle change, or other?
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Your answer
Write down 3 things you love about yourself.
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Your answer
What are your values? Give me about 5-10 values.
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Your answer
Where do you want to be in 6 months…a year? What do you look like, feel like, do, etc.?
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Your answer
What are the biggest obstacles that have kept you from reaching a goal on your own already?
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Your answer
Who do you feel supports you? Who/what holding you back?
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Your answer
What are your priorities?
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Your answer
Describe your current state of mind to Training and Nutrition. E.g. Motivated! just need more support, structure, and/or.
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Your answer
How active is your job? E.g. I sit at a desk most of the day.
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Your answer
What Gym do you use/train out of?
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Your answer
Do you have any allergies or intolerances?
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Your answer
What are your favourite foods?
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Your answer
Any foods that you dislike?
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Your answer
How much water do you drink on an average day?
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Under 1 Litres
1-2 Litres
2-3 Litres
3 Litres +
How much sleep do you get per night, on average?
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Your answer
Tell me how you feel when you wake up in the morning? A little bit thirsty and dizzy.
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Your answer
On a scale of 1-10. 10 being the BEST and 1 being TERRIBLE. How are you feeling?
Digestion
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Choose
1
2
3
4
5
6
7
8
9
10
Energy Levels
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Choose
1
2
3
4
5
6
7
8
9
10
Sleep
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Choose
1
2
3
4
5
6
7
8
9
10
Stress
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Choose
1
2
3
4
5
6
7
8
9
10
Strength
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Choose
1
2
3
4
5
6
7
8
9
10
Recovery
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Choose
1
2
3
4
5
6
7
8
9
10
Have you ever tracked your food intake? (Calories or Macros)
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I've never tracked my food
I have tracked my food a little bit
I have tracked food, calories and macros
How many days a week would you like to workout?
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3
4
5
6
Other:
What has work out for you in the past?
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Your answer
Are you able to track your food intake?
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Yes
No
Maybe
Other:
Would you prefer a meal plan or macro tracking?
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Meal Plan
Macros
Discuss on our Accountability Call
Do you have any questions for me?
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Your answer
Where did you hear about my services?
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Your answer
What day and time is best to contact you for a chat?
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Your answer
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