Were you referred by a current client? If so, who?
Your answer
Gender *
Birthday *
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Age *
Your answer
Height (in inches) *
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Current Weight (in pounds [lbs]) *
Your answer
Facebook Profile Link
Your answer
Instagram Username
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Is your *primary goal* fat loss? *
What kind of workouts/training do you do? (ie: bodybuilding style, powerlifting, Crossfit, OTF, etc). *
Your answer
How active are you outside of the gym (1 sedentary -> 10 extremely active) *
Sedentary
Extremely Active
What exactly are you wanting to achieve with coaching from me? What are your goal(s) short term and long term? *
Your answer
Have you ever worked with a personal trainer (either in person or online)? If yes, what was your experience? *
Your answer
Do you have any health issues or past injuries we should know about, such as asthma, diabetes, back pain, etc, we should know about? If so, please explain here. *
Your answer
Please list any medications you're taking. *
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Are you pregnant or might be pregnant? *
Is there anything to prevent you from working out? If yes, explain. *
Your answer
Are you already experienced w/ Flexible Dieting, IIFYM, tracking macros? *
Are you currently tracking your macros? If yes, what is the calories/macros intake? *
Your answer
Have you had success or trouble following diets in past? *
Your answer
Are you an emotional eater? *
Do you binge on food? What's the trigger(s)? *
Your answer
How often do you consume alcohol? *
Do you smoke? *
Do you consider yourself motivated to reach your goal? *
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