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1:1 COACHING FORM

First Name

Last Name

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What are your specific fitness goals? *

I want to lose fat

I want to gain muscle

I want to maintain

Other (provide details below)

If other, be specific

How often do work out per week? This can be any training involving weights bodyweight. *

Once per week

2 times per week

3 times per week

4 times per week

5 times per week

6-7 times per week

None

When are you looking to start training? How many days per week?

Do you have any existing medical conditions, health concerns, injuries or physical limitations that may affect your exercise routine?

On a scale of 1 to 10, how motivated are you to make changes to improve your health?

Have you previously worked with a health coach or wellness professional? If yes, please describe your experience.

Consultation Preference

Phone call

Video Call

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