Coaching Application
Full Name
*
Email
*
Phone
*
What's your Instagram handle or Facebook name?
*
What are your fitness and/or health goals?
*
To lose body fat 10-20lbs
To lose body fat 20-40lbs
To lose body fat 40-100+ lbs
To optimize my health, I have MILD symptoms (fatigue, poor gut health, acne, cycle irregularity/issues, brain fog, cravings, trouble with gaining/losing weight)
To optimize my health, I have MODERATE symptoms (fatigue, poor gut health, acne, cycle irregularity/issues, brain fog, cravings, trouble with gaining/losing weight)
To optimize my health, I have INTENSE symptoms (fatigue, poor gut health, acne, cycle irregularity/issues, brain fog, cravings, trouble with gaining/losing weight)
To gain strength
To gain muscle mass
To improve my gym performance or sport performance
To improve mild pain/muscular imbalance
To improve my nutrition
To improve my mindset
To improve my habits and behaviors
To improve my consistency
Other
What services are you most interested in? Select as many as you'd like.
FULL TRANSFORMATION COACHING (Looking to get an amazing transformation with an all inclusive personal coach? I will write you a custom workout plan that you will follow with full instructions and videos, along with nutrition coaching sessions. We will also optimize your personal movement, water, sleep, stress, and supplement routine for the best results. Most importantly, I will hold you accountable to following through on our plan.)
NUTRITION COACHING (Work with me to master your nutrition habits. If nutrition seems to be the hardest thing for you, and you don’t need/want a training plan, this is the option for you.)
SEMI-PRIVATE PERSONAL TRAINING + NUTRITION COACHING
SEMI-PRIVATE PERSONAL TRAINING
PERSONAL TRAINING + NUTRITION COACHING
PERSONAL TRAINING
TRAINING PROGRAM (Are you looking for just a custom training plan? I will write you a custom workout plan that you will follow with full instructions and videos.)
What is/are your biggest challenge(s) in reaching these goals?
*
How Important Is It To You That You Reach These Goals
*
Kind of, I’m not sure I’m there yet to really make changes.
Very, I’m ready to make a change.
Extremely, I’m fed up with my situation and I am fully committed to changing my situation.
No elements found. Consider changing the search query.
List is empty.
Tell me a little more about you! What city/state do you live in? How old are you? What do you do for work?
*
Did someone refer Me/Strong and Healthy to you? Please list their name.
*
What made you decide to reach out to Strong and Healthy?
*