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Remote Coaching Application
Please answer the following questions to the best of your ability.
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* Indicates required question
Email
*
Your email
Name
*
Your answer
What is your primary fitness goal?
*
Your answer
Do you exercise regularly?
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Yes
No
What types of physical activity do you enjoy doing? (If any)
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Your answer
Exercise experience
*
0-2 years
2-5 years
5 + years
No experience
What type of exercise and how often?
*
Your answer
Current training location/gym
*
Your answer
Please list all equipment that you have available
*
Your answer
Do you have any known health issues?
*
Your answer
Please list any past injuries or surgeries that may impact your ability to exercise
*
Your answer
Do you have any known allergies?
*
Yes
No
Are you currently taking prescription medications?
*
Yes
No
Please list all allergies and current medications
Your answer
Occupation
*
Your answer
How many hours of sleep do you get/night
*
Your answer
Briefly describe your energy levels throughout the day
*
Your answer
Do you have any known food Intolerances?
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Your answer
Have you ever had nutritional coaching before?
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Yes
No
What previous diet/nutrition plans have you followed?
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Your answer
Are you planning to lose, maintain, or gain weight while training with us?
*
Lose (Calorie Deficit)
Maintain
Gain (Calorie Surplus)
Is there anything else you would like for me to know prior to our call?
*
Your answer
A copy of your responses will be emailed to the address you provided.
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