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Nutrition & Fitness Application
Thank you for taking the time for this application, please answer things as accurately and in as much detail as you can as this will later be used to customize and create your plan.
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Email
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Your email
Your first and last name
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Your answer
Email
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Your answer
What is your birthdate?
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Your answer
What is your age
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Your answer
What is the best number to reach out?
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Your answer
What is your height?
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Your answer
What is your current weight?
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Your answer
What has made you reach out to a coach for support?
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Your answer
Which coaching options are you interested in?
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Nutrition
Virtual Fitness Programs
Personal Training (in person)
Group Training
Group Challenge
Required
If you're interested in the virtual fitness program, give details on the equipment you have access to
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Your answer
Why LiteFIT? Why now?
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Your answer
What are your short term goals 8-12 weeks?
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Your answer
What are your long term goals? 24+ weeks
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Your answer
What motivates you?
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Your answer
Have you recently been dieting? If so please explain your diet. Where did you find it? Who set it up? What is involved with the diet? How long have you been doing it?
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Your answer
If you have been counting calories or Macro's recently, what were your numbers?
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Your answer
What does your typical breakfast, lunch, dinner, snacks and drinks look like?
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Your answer
Do you currently workout? If yes describe them, how often, duration, and what you do. Cardio/weights/yoga/crossfit etc.
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Your answer
Do you know your average daily steps? What are they?
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Your answer
Medical History and Health Risk Factors
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Diagnosed Heart Problem
20+ Pounds Overweight
Little to no exercise in last 6 months
High Blood Pressure
Diagnosed Stroke
Type 1 or 2 Diabetes
Family History of Health Problems
Other:
Required
Please provide details if you checked any of the previous question.
Your answer
Please list any surgeries and/or major injuries:
Your answer
Please list any current medications and how long you have been on them:
Your answer
Please provide me any dietary supplements you are currently taking:
Your answer
Do you feel that you have any limitations I have not mentioned that need to be taken into consideration prior to you beginning and fully participating in this program? If so, please explain.
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Your answer
Do you have any food allergies? If so, please explain.
Your answer
What challenges have you faced regarding hitting your goals?
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Your answer
If there is one thing that I could make happen for you in this coaching program, what would that be?
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Your answer
When we begin to work together, are you going to be 100% committed to the program?
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Yes
No
On a Scale of 1-10 how committed are you to seeing your goals through?
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1
2
3
4
5
6
7
8
9
10
If you are committed to seeing your goals through. Type below "I am committed."
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Your answer
Thank you for taking the time to fill out this application very detailed! I know it was a little lengthy but it's just so we can get to know you the best we can and come up with the perfect plan for you!
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