1:1 Coaching Application

You can always press Enter⏎ to continue

Now create your own JotForm - It's free!Create your own JotForm

Create your own JotForm

JotForm

JotForm mascot Podo

1:1 Coaching Application

1:1 Coaching Application

Please answer each question with as much detail as possible. This information is for me only and will not be shared.

26Questions

1
FIRST Name* This field is required.
First Name
2
LAST Name* This field is required.
Last Name
3
Birthday* This field is required.
Date
Year
Month
Day
4
Phone Number* This field is required.
Area Code
Phone Number
5
Email* This field is required.Please double check this as I will be reaching out via email
example@example.com
6
Where do you live? (City & State, Country if not US)* This field is required.Not your full address.
7
What is your occupation?* This field is required.Trying to get a gauge on how sedentary or active you are, whether your job is high-stress, etc.
8
How much do you currently weigh? (Pounds)* This field is required.
9
How tall are you? (Feet, Inches)* This field is required.
10
Current body fat percentage? (an estimate works)* This field is required.
11
What type of coaching are you interested in?* This field is required.
Nutrition only
Training & nutrition
Training only
Open to suggestion
12
What is your main goal(s)?* This field is required.What would you like to achieve by working with me?
Huge
Large
Normal
Small
Ok
Ok
13
What's your biggest struggle when it comes to achieving this goal(s)?* This field is required.In your opinion, why have you not already achieved this goal
Huge
Large
Normal
Small
Ok
Ok
14
What has motivated you to make this change now? * This field is required.
Huge
Large
Normal
Small
Ok
Ok
15
How did you hear about me as a coach and why do you think I, specifically, can help you achieve your goal(s)?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
16
Have you worked with an online coach before?* This field is required.
YESNO
17
If YES, what worked and/or didn't work with that coach?
Huge
Large
Normal
Small
Ok
Ok
18
Do you currently exercise?* This field is required.
YESNO
19
If yes, about how many hours per week?Strictly dedicated exercise. If you have an active job, don't include that yet.
Less than 2 hours
3-4 hours
5-7 hours
8 or more hours
20
What types of exercise (or sport/other activity) do you typically do?
21
Do you have any nutritional preferences?* This field is required.Do you only eat specific things/diet like paleo, vegan, vegetarian, low carb, etc.
22
Have you ever tracked your calorie intake? (macros)* This field is required.
YESNO
23
Do you currently track your calorie intake? (macros)* This field is required.
YESNO
24
Are you willing to track your calorie intake? (macros)* This field is required.This is a non-negotiable for me. If you are not willing to track, we are not a good fit and I suggest finding another coach.
YESNO
25
Do you have any injury history or health concerns I should know about?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
26
Are you 100% committed and serious about achieving your fitness goals?* This field is required.I can give you all of the information and provide the accountability but it is up to you to do the work. If you cannot completely commit I would suggest revisiting this application when you are ready.
YESNO
Should be Empty:

Question Label

1 of 26See AllGo Back

Save & Continue Later

Your form is saved successfully!

If you want to continue answering your form later, please enter the email address you would like to send the link to:

Please enter a valid email address.

Something went wrong while saving your answers. Please try again.

Email has been sent successfully.

Save your progress

OR

Already have an account? LOGIN

Skip Create an Account

Save your progress

Name

Email Address

Password

I agree to theTerms of ServiceandPrivacy Policy

Your form submission has been saved as a draft.

If you want to continue answering your form later, please enter the email address you would like to send the link to:

Save your progress

OR

Username or email

Password

Forgot Password?

Your form submission has been saved as a draft.

We’ve sent you an email with a link to complete your submission.