Online Training Application

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Email *

Name *

Address

Phone Number *

Age/birthdate *

Height *

Current weight

best guess if unknown

Body fat % if known

how was it measured?

How do you identify? *

transgender

non-binary

male

female

prefer not to say

Other:

If you answered other in the previous question, please describe.

What are your pronouns?

What are your 3 main goals? Please be as specific as possible. *

Why do you want to achieve these goals? Again, please be as specific as possible. *

What do you think are your challenges in achieving these goals? *

Have you tried to reach these goals before? What happened? *

What is your plan for when you reach your goals? *

What is your motivation level right now? *

low

moderate

high

How confident are you in yourself? *

Not confident at all

Very confident

Which statement(s) best describes you? *

I am very self motivated, and I can complete tasks/workouts on my own without prompting.

I usually follow through on my plans to exercise, but sometimes I don't feel like it so I don't.

I have a difficult time completing workouts and other tasks if I don't have someone directly supervising me.

I know I SHOULD exercise, but I have a hard time motivating myself to do it.

I will exercise if I go to a gym, but I have a hard time doing it at home.

I will complete exercises/tasks if I have a program/plan, but I feel lost on my own.

It doesn't matter if someone is expecting me to complete my program, I won't do it unless I want to.

I will complete tasks/workouts if I know that someone is expecting me to do them.

Required

Space for any additional comments about the previous question.

Do you have any concerns about having a fitness program built for you, or anything that you really DON'T want to do? *

What is your current activity level? *

Sedentary: Desk job or not working with little to no exercise

Little Activity: Exercise moderately 1–3 times a week. Or no exercise, but slightly active job.

Moderate: Exercise moderate 2-3 times a week with sedentary job. Or slightly active job, and exercise moderately 1-3 times a week.

Active: Physical work, exercise hard 5+ days a week

Highly Active: Physical work, exercise very hard 6+ days a week

Do you have any medical/health issues? *

What is your previous exercise experience? Type, frequency, time frame. Did you enjoy it? *

Are you currently exercising? If so, what and how frequently. *

Do you have any exercise limitations? If yes, please describe. *

Do you have any current or recurring joint, muscle, tendon or ligament pain? Where? *

Do you have any current or past injuries? If yes, please describe. *

Do you experience any pain or discomfort during exercise? *

Have you lost or gained a large amount of weight before? Please describe. *

Have you followed a nutrition plan or diet before? *

Yes

If yes, please describe: what kind, when, how long, how successful was it?

Do you, or have you ever had disordered eating? *

Are you under high amounts of stress? *

Yes

Are you pregnant? *

Yes

Maybe

Are you breast/chest feeding? *

Yes

Do you have stress incontinence? *

Leaking of urine when coughing, sneezing, jumping, running, etc.

Frequently

Occasionally

Rarely

Never

Do you have urge incontinence? *

Leaking of urine when the bladder is full

Frequently

Occasionally

Rarely

Never

Do you have anal incontinence? *

Inability to hold in gas and/or stool

Frequently

Occasionally

Rarely

Never

Do you have diastasis recti? *

separation of the abdominal muscles

Yes

Unknown

Do you or have you ever had a hernia? *

Yes

Do you have pelvic organ prolapse? *

Uterine (uterus)

Cystocele (bladder)

Rectocele (rectum)

None

Required

Have you given birth? When? Any complications? *

Do you track the following biomarkers? *

blood pressure

waking heart rate

heart rate variability

none of the above

Required

What kind of motivation works best for you? *

Where will you be doing your workouts? *

Large gym

Small gym

Small fitness room at work or apartment building

Home

Other:

Required

If other, please describe

If you will not be exercising at a large gym with a wide variety of equipment, what will you have available to you?

Are you willing to purchase weights or other equipment? *

Yes

Maybe

Is there anything else you would like us to know about you?

Submit

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