First Name
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Last Name
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Instagram Handle
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Phone
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Email
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Which of the following best describes your current goals/challenges? (select all that apply)
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I want to lose fat (lose weight)
I want to build muscle (gain weight)
Improve Performance (strength, endurance, etc.)
I want to improve my overall health, increase energy, etc.
Which best describes your nutrition for the last 30 days?
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I track my meals/macros
I'm following a meal plan
I have tracked my food or diet in the past, but have not been lately.
I have no idea where to start with my diet/nutrition
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Have you been diagnosed with an eating disorder?
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Yes
No
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What is it you are looking to gain from having a coach?
What is the biggest hurdle you’ve been trying to overcome with your fitness?
What is your commitment level to your personal results?
1. I’m extremely committed. I’m sick of my own bullshit, and I will do whatever it takes.
2. I’m committed enough to invest in my goals but I’m afraid of “missing out” on social events.
3. I know I need help to make a change but I’m not sure if I’m ready to fully commit.
Anything else you'd like to add before booking?
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