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1 to 1 Coaching Application
Date of birth
*
First Name
*
Last Name
*
Best Contact Number
*
Email
*
Gender
*
A
Male
B
Female
What is your experience in the gym
*
A
Limited to no experience
B
I worked out in the past and want to get back into it
C
I currently work out a few times a week
D
I regularly workout consistently
What are your specific goals for this program?
*
What sort of exercise do you enjoy?
*
Feel free to elaborate on the above
What challenges have stopped you from achieving your goals in the past?
(Injuries, Lack of accountability, Lack of motivation, not seeing results etc)
*
Do you have access to a fully equipped gym?
*
A
Full gym
B
Limited Gym (Smaller boutique studio, apartment building gym, etc)
C
Home gym
D
Limited Home Equipment (only 1 or 2 pieces, eg. Resistance bands and/or DB's only)
E
No Equipment or Gym Membership
How many days per week can you realistically commit to training?
*
What does a typical week of physical activity look like for you? (Other sports training etc)
*
Do you have any past or current injuries that I need to be aware of? If you are currently managing an injury, Include any prescribed exercises by other health professionals (eg: Physio)
*
Are there any exercises or movements that you struggle with due to a restriction or other?
*
Do you have any specific nutrition goals that align with your training? (Fat loss, muscle gain, maintenance)
*
How comfortable are you with compound lifts (squat, deadlift, overhead press, etc)?
*
A
Not confident
B
Have done in the past but not super confident with certain aspects of technique
C
Confident in my knowledge and ability
Which of these would you need the most?
*
A
Structure
B
Accountability
C
Education
Coaching Options: All coaching is billed every 4 weeks, covering your ongoing programming, delivered through the AMP Coaching app. If you’re unsure which option suits best, just pick what feels right. We’ll confirm it together before starting.
*
A
Standard Plan (online Only)- $70-80/week including custom training plan, weekly program updates and optional monthly zoom check-in
B
Standard Plus Plan – $95–105/week including everything in the standard plan + a monthly in person 1-to-1 session with me at The Movement South West
C
Premium Plan (online only) – $80–95/week including everything in the standard plan + weekly video review for technique/form checks + priority messaging support
D
Premium Plus Plan – $105–120/week including everything in Premium plan + a monthly in person 1-to-1 session with me at The Movement South West
I require a minimum 8 week commitment to take you on as a client, are you happy to commit to this minimum timeframe?
*
A
Yes
B
No
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