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Client Application Form

Full Name

Age

Email Address

Location

What are your short-term goals? (Next 3 months) Try to be specific

What are your long-term goals? (6-12 months, even years)

How would you describe your training experience?

How would you describe your training experience?
A
B
C

Describe your training experience in more detail

What does your current training program look like?

What equipment do you have access to?

How many days per week can you train?

How many days per week can you train?
A
B
C
D

What do you struggle with most in your training?

What type of coaching are you interested in?

What type of coaching are you interested in?
A
B

If Single Focus, which discipline? (Leave blank if you selected Multiple Focus)

If Single Focus, which discipline? (Leave blank if you selected Multiple Focus)
A
B
C

Do you have any current injuries that are affecting your training?

Do you have any historic injuries that impact your training?

May I use your training videos or feedback as promotional content on social media?

May I use your training videos or feedback as promotional content on social media?
A
B
C
PAR-Q (7 Questions) The following 7 questions are a standard physical activity readiness check. Please answer honestly. If you answer Yes to any question, this doesn't prevent you from coaching — we'll discuss it on our initial call.

Has your doctor ever said that you have a heart condition or high blood pressure?

Has your doctor ever said that you have a heart condition or high blood pressure?
A
B

Do you feel pain in your chest at rest, during daily activities, or when you do physical activity?

Do you feel pain in your chest at rest, during daily activities, or when you do physical activity?
A
B

Do you lose balance because of dizziness, or have you lost consciousness in the last 12 months?

Do you lose balance because of dizziness, or have you lost consciousness in the last 12 months?
A
B

Have you ever been diagnosed with a chronic medical condition other than heart disease or high blood pressure?

Have you ever been diagnosed with a chronic medical condition other than heart disease or high blood pressure?
A
B

Are you currently taking prescribed meditation for a chronic medical condition?

Are you currently taking prescribed meditation for a chronic medical condition?
A
B

Do you currently have a bone, joint or soft tissue problem that could be made worse by becoming more physically active?

Do you currently have a bone, joint or soft tissue problem that could be made worse by becoming more physically active?
A
B

Has your doctor ever said you should only do medically supervised physical activity?

Has your doctor ever said you should only do medically supervised physical activity?
A
B

Is there anything else about your health you think I should know before we begin?

Is there anything else about your health you think I should know before we begin?
A
B
By submitting this form you confirm that the information provided is accurate to the best of your knowledge, and that you will inform your coach of any changes to your health that may affect your training.

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