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Please fill the following ^*

First Name ^*

Last Name ^*

Email ^*

Phone Number ^*

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What's your current weight (in lbs) ^*

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And your height? ^*

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Gender? ^*

Female

Male

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Where'd you find us? ^*

Youtube

Word of mouth

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What style of coaching are you looking for? ^*

We offer 2 different coaching options.

Some of our clients want a fully tailored, white glove service. Others just want some strategy & accountability.

Choose the option that best describes what you feel you need.

We also believe in price transparency, so each coaching option has price ranges included.

I want targeted, fully custom health & performance coaching (from $250/wk)

I just need some structure & a push in the right direction (From $50/wk)

Neither of these options really work for me.

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How many days do you work out on average, per week? ^*

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What do you normally do when you work out? ^*

Click all that apply.

Go running

Go walking

Biking

Lift weights

Group classes

Nothing, I've never really worked out

Sports (golf, basketball, etc)

Other

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Do you have any nagging pain or injuries in these areas? ^*

Check all that apply

Neck

Shoulder/s

Elbow/s

Low Back

Hip/s

Knee/s

Ankle/s

Other

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What areas of your body do you want to see the most improvement in? ^*

Arms / Shoulders

Chest

Upper Back

Legs

Glutes

Abs / Midsection

Other

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How much weight are you looking to lose? ^*

Not looking to lose any. Just body recomposition.

10+lbs

20+lbs

30+lbs

40+lbs

50+lbs

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Rank your daily stress levels, on average. 1 being no stress, 5 being very stressed.

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How much are you sleeping per night, on average? ^*

Around 4hrs per night

Around 5hrs per night

Around 6hrs per night

Around 7hrs per night

Around 8hrs per night

8+ hrs per night

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Rank your daily hunger levels, on average.

I'm always hungry.

I have an average appetite.

I'm never hungry.

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Do you have strong cravings for sugary / salty foods often?

Yes.

No.

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Have you been dealing with any of these issues lately? ^*

Low Energy

Lack of Desire to Do Anything

Low Sex Drive / Libido

Poor Sleep

High Stress

Irritability / Uncharacteristic Anger

Loss of Muscle Mass

None of the Above

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How active is your job / day to day life?

Very sedentary. I'm sitting most of the day.

Kind of sedentary. I move around a bit.

Pretty active. I move around a good bit.

Very active. I'm constantly moving around.

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How long have we been connected prior to you completing this quiz? ^*

Less than 30 days

Less than 60 days

Less than 90 days

More than 90 days

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How often do you travel for work? ^*

Daily

Weekly

Bi-Weekly

Monthly

Quarterly

Rarely

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Thanks for getting this application done! I'll take a look & reach out with our next steps!

Please shoot me a message on either LinkedIn, or a text @ 662.610.4268 & we'll put your tailored game plan together!

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