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Fitness Coach Request Form - Tells us about you - We are listening!
1.
Name
2.
Date
Date / Time
Date
January
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3.
Phone Number
4.
E-mail
5.
Please provide us with a brief description of your current workout regime/schedule: *
6.
Why is now a good time for you to try working with a Fitness Coach?
7.
What type of workout services are you interested in? *
Free Strategy Session
1x per week one/one session
2x Week one/one session
3 or more one/one sessions
Semi-Private Training
Small Group Traiing
Nutrition Coaching
Program Development
Heavens Get to Know Session (Included with membership)
Body Makeover Challenge (11 week transformation package)
8.
Do you have a preference for a Fitness Coach you would like to work with?
If yes, please let us know who...
If no, do you have a preference of male or female trainer?
9.
What time of day(s) is best for you to train? *
When do you have the most energy for your workout?
10.
What days of the week work best for you to train? *
11.
Please give us your "big picture" goals.
What does success look like for you?
What does it feel like for you?
12.
Are you working with any injuries or medical conditions, old or new, we should know about? We specialize in adaptability and rehabilitation. Tells us everything so that we can design the best program for your needs.
13.
What has been your greatest barrier to living your healthiest, fittest life?
14.
Please provide us with any other information you feel will help your coach assist you in achieving your training goals?
We are listening!
15.
Making lasting, sustainable changes takes time. Are you ready to shift your habits and mindset?