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One to One Coaching Application
Hello! This application is for 1:1 coaching.
This form is an opportunity for me to get to know more about you and your goals.
PRICING £35 for 60 minutes online or in person.
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* Indicates required question
Email
*
Your email
First and last name
*
Your answer
Phone number
Your answer
On a scale of 1 - 5, how happy are you with your current physique, strength and fitness?
(extremely unhappy)
1
2
3
4
5
(extremely happy)
Clear selection
Instagram handle or Facebook name
e.g. @mamalifelifted
Your answer
How would you rate your knowledge of health and fitness? 1 very little - 5 more than the average person.
1
2
3
4
5
Clear selection
What is the ultimate goal you would like to achieve by working one to one with me?
*
Lose weight
Strengthen core and pelvic floor
Build muscles
Keep fit
Stay consistent with exercise
Other:
Required
Please describe your typical day
At the office
Mostly at home
Physical work
Long daily walks
Other:
Clear selection
How often do you exercise for more than 30 minutes?
Almost every day
Several times per week
Several times per month
Once in a while
Never
Clear selection
How often do you walk for more than 20 minutes at a time?
Every day
3 - 4 times a week
1 - 2 times a week
A couple of times a month
Clear selection
How many times per week would you like to work out?
1 - 2 times
3 - 4 times
5 + times
Clear selection
How much time do you want to spend working out?
15 - 30 minutes
30 - 45 minutes
45 - 60 minutes
I don't know
Clear selection
What time of day do you want to workout?
Your answer
What kind of exercise do you prefer?
Resistance training
Body weight
HIIT (high intensity interval training) or circuit training
Aerobics
Running
Walking
Cycling
Which areas need the most attention?
*
Belly
Butt
Legs
Arms and shoulders
Back
Required
What level of intensity do you want from a fitness coach?
Not intense
A little intense
Sometimes intense
Intense
Extremely intense
How would you describe your ideal fitness coach?
High energy
Knows when to give me tough love
Calm, cool and collected
Always positive
Other:
Tell me about your health and fitness journey, what have you struggled with the most? E.g. sticking to an exercise routine, being consistent, all or nothing behaviour (going all out for a week or two and then stopping).
Your answer
Do you have any health issues/conditions/physical ailments that could prevent you from performing intensive exercises such as HIIT or resistance training?
*
Your answer
Are you ready to commit to putting in the work and showing up consistently for yourself?
Heck yes!
I'm nervous...but yes!
I'm not sure yet and would like to learn more.
Clear selection
A copy of your responses will be emailed to the address you provided.
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