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Ben Scott Coaching: Application
Full name
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Email
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Age
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Current height
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Current weight
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On a scale of 1–10, how active would you say you are currently?
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1
2
3
4
5
6
7
8
9
10
Sedentary
Highly active
What's your main goal right now?
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What would make the next 3 months a success for you?
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What have you tried before, and what got in the way?
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How many days a week can you realistically train?
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Where do you train (gym, home, both)?
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A
Gym
B
Home
C
Both
How long can you give each session?
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A
Under 30 minutes
B
30–45 minutes
C
45–60 minutes
D
60+ minutes
Do you have any injuries or health conditions we should know about? (Please check with your GP before starting.)
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Are you currently taking any medication that affects exercise?
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Are you ready to invest £200 per month in coaching?
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A
Yes
B
Not sure
Anything else you'd like me to know?
Consent
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See my
privacy policy
.
I agree to be contacted about my application.
Health information consent
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I consent to Ben Scott Coaching using the health information I've shared to assess whether coaching is suitable and safe for me.
Submit application