First Name *

Last Name *

Phone *

Email *

Date of birth *

How would you describe your current fitness level? *

Beginner

Intermediate

Advanced

What are your primary fitness goals? *

Weight Loss

Muscle Gain

Overall Health

Stress Relief/Mental Well-being

Do you have any specific short-term (3-6 months) or long term goals (1 year or more)? *

Do you have a support system (friends, family) that encourages your fitness goals? *

What challenges or obstacles do you foresee in reaching your goals? *

Do you have any pre-existing medical conditions or injuries? *

Do you currently follow any specific fitness or nutrition plan? If yes, please describe. *

Have you had experience working with a fitness coach before? If so, tell me about it. *

How committed are you to achieving your fitness goals? *

I am 100% committed and ready to work

I am fairly committed but need more motivation

I have no interest in putting in the work to reach my goals

Please list any additional questions/concerns or relevant info I should know before we set up a call:

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