Application for Coaching

New Client & Athlete Application Form

Please fill this form out and schedule your consultation call with me once you submit this form! Be as detailed as possible.

Full Name *

Instagram Handle *

Age and DOB (add both) *

Phone *

Location *

Time Zone *

Current Weight? *

Current Height? *

Are you a lifestyle client or a competitor? *

Lifestyle

Competitor

Functional Case (Gut protocol, hormonal mending etc)

Not sure yet

Training Experience *

Beginner

Intermediate

Advanced

Explain your current eating regimen. If you follow macros please add your total intake with total calories along with a food log. *

Do you have any diagnosed/undiagnosed eating disorders or do you have a history of them? *

What are your goals with our time together or any information that will help me understand your needs. *

Describe your current training and training style. *

Are you doing any cardio if so what type? *

Do you have any perceived limitations when it comes to working out/training for your goal? Injuries? *

Do you have any medical conditions? List any medications if so *

Any hormonal birth control? If so what type and how long have you been on? *

Are you interested in or using Performance Enhancing Drugs? If so list them and their dosages. *

Is there anything else you feel I should be aware of? *

Email *

How did you find me/who referred you? *