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Coaching Application

What is your name?

What is your email address?

What are your primary fitness and wellness goals?

What are your primary fitness and wellness goals?

On a scale of 1 to 10, how would you rate your current level of physical activity?

On a scale of 1 to 10, how would you rate your current level of physical activity?
Sedentary, InactiveAverageActive, All day

On a scale of 1 to 10, how would you rate your current level of mental clarity, mental stability? (feel free to leave no answer if you do not wish to share)

On a scale of 1 to 10, how would you rate your current level of mental clarity, mental stability? (feel free to leave no answer if you do not wish to share)
Needs WorkAverageStrong

Have you previously worked with a fitness/wellness coach or participated in a structured program?

What motivates you to prioritize your health and fitness?

Are there any specific challenges or obstacles you anticipate facing on your fitness/wellness journey?

How would you describe your current diet and nutrition habits?

How would you describe your current diet and nutrition habits?

What types of exercise do you prefer?

What types of exercise do you prefer?

What is your preferred method of communication for coaching sessions and check-ins?

What is your preferred method of communication for coaching sessions and check-ins?

What is the timeline you seek to achieve your goals?

Are you coachable and open to change?

Are you coachable and open to change?
A
B
C

Any questions for the coach?

Please be aware that the ONLINE 1-on-1 Coaching services start at $200.00 USD per month.

Please be aware that the ONLINE 1-on-1 Coaching services start at $200.00 USD per month.
A
B
C