Coaching Application

This form will take around 20 minutes to complete.

It is best if you are uninterrupted to fill this out, as the form will reset if you leave it, therefore, leaving all your answers blank, and you would have to start again.

Information to be submitted includes contact info, training background, current training status, health information, nutritional information, and goals.

If you have access to any previous training or nutritional plans, please feel free to attach them. Body photos (front, side, back, side) in a bikini or bra top and shorts are to be submitted with this form.

Once I receive your answers, I will reach out to you via email.

Work hard. Be amazing.
Coach, A.

Please fill out this form completely.

Name

First

Last

Email address*

Phone*

Facebook Username

What is the main reason you are reaching out today?*

Current Age*

Weight (pounds)*

Height (feet, inches)*

Photos

Make sure the photo is clear, good lighting, full body shot, head to toe, arms out at sides, stand tall, in a two piece, or bra/underwear. We will use the same outfit, each time, you submit photos. Choose wisely.

Front Image

Side Image

Back Image

Tell me about your current training?*

Have you ever been on a training program before? Feel free to describe any exercises, reps, sets, cardiovascular work you have done in your previous trainings. Feel free to attach any previous training programs you have been on OR are currently doing.

Training Program

Feel free to add a file containing any previous training you have done. You can upload up to 5 files in the following formats: jpg, jpeg, png, gif, doc, pdf, xlsx, docx,xls,

In the last 3-6 months have you been exercising at least 3x per week, consistently?*

Feel free to explain your current training/workout frequency and structure.

What frequency per week can you commit to training?*

Include number of days per week, and length of each training session (in minutes or hours) What can you commit to considering all the other obligations you have in your life.

Where will the majority of your training be performed?*

Home Workouts

Gym Workouts

Hybrid | Blend of both.

If working out from home, exclusively, list all your equipment you have available.

A complete listing of home gym equipment.

What is your current level of experience? *

What equipment do you frequently use - at home, or in the gym, with your workouts? Examples, include machines, cables, dumbbells, barbells.

Comment/Question/Your Story*

Tell me your story. Your experience with training, what you are currently doing for training, in gym, or at home, and what you would like to achieve with your fitness.

Do you have any current health issues that I need to be aware of?*

Have you suffered any majority injuries- when and where? Have you had a recent surgery? Do you have any chronic aliments? Limitations, restrictions, extra information?

Do you smoke? *

How much and how often?

Are you currently taking any medications?*

Please describe dosages, and type of mediation and what it is treating.

Tell me about your work; your profession? *

What is your day like? Hours worked? Shift work? What do you do for living? Any aspects of your work you find stressful?

How is your sleeping?*

Describe. What time do you go to bed? Rise?

Are you married, or in a long term relationship?

Are they willing to support you in your new change of lifestyle?

What are you hobbies? How do you relax?

Do you have any hobbies? What is your outlook on life?

Do you have any food allergies or intolerances? Please describe.*

Eggs, wheat, gluten intolerance, milk, dairy, nuts are common allergy foods. Are there any foods that you consume that may cause you to have gas, bloating, stuffiness, or congestion?

Do you drink? Any vices for certain foods?*

Have you ever binged on food? If so, what foods? When? How much? How often?

Have you ever been on a nutritional plan before?*

If so, how long and what kind? Who designed the program? If you have an example of the plan please attach below.

Nutrition Plan Example

Feel free to add a file containing any previous nutrition plans you have done. You can upload up to 5 files in the following formats: jpg, jpeg, png, gif, doc, pdf, xlsx, docx,xls,

Day 1 | Example Day

As an example, you can give me an example of what you would consider a good day, a bad day, and perhaps medium/okay day nutritionally.

Day 2 | Example Day

As an example, you can give me an example of what you would consider a good day, a bad day, and perhaps medium/okay day nutritionally.

Day 3 | Example Day

As an example, you can give me an example of what you would consider a good day, a bad day, and perhaps medium/okay day nutritionally.

Is there anything else you would like to mention about your dietary/nutrition habits?

If on previous nutrition plans, what have you found works well? What did not work so well with your previous nutritional plans?

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Coaching Application

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