1:1 Online Personal Training Inquiry Form

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What is your full name?* This field is required.

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What is your email address?* This field is required.

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How old are you?* This field is required.

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How tall are you? (inches)

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Do you have any past or current health restrictions I should know about?* This field is required.

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Are you on any medications currently?* This field is required.

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What would be your goal for our 1:1 Online Personal Training?

Build Muscle/Mass

Lose Body Fat

Maintain

Other

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If you track your caloric intake, what are your macros/calories set at right now?

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Have you ever had an online coach? If yes, describe the outcome of that experience.* This field is required.

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Do you have access to a gym?(with dumbbells, barbell/weights, cables etc?)

YESNO

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Are you willing to invest in yourself and commit to 3 months with me?* This field is required.

YES - I am willing to invest

I can't afford to invest in myself right now

Other

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If we feel like it's a great fit and want to move forward, and I told you investing for a month was $400.00 (this is not the actual cost) what would your response be?* This field is required.

SIGN ME UP! I can pay in full.

SIGN ME UP! I need a payment plan.

I am not ready to invest in my life and my health & fitness.

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Tell me a BIG LIFE GOAL of yours, and something FUN about yourself! * This field is required.

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Thank you so much for your Inquiry! Please allow 24hrs for a response via email!