You Are One Step Closer To Getting Healthier! Please Fill Out The Application Below.

First Name *

Last Name *

Email *

Phone *

Occupation? (Where do you work? Desk job? Active job? etc.) *

Age? *

Weight? *

What Are Your Health & Fitness Goals? Lose 20 Lbs? Be Happy And Healthy? Tone Up? Build Lean Muscle? Overcome Depression And Anxiety? Manage Stress? Be More Confident? Etc. (Explain In Depth) *

Explain to us WHY. What is driving you to make these changes? *

What have you tried in the past and why hasn't it worked for you? What has kept you from achieving your goals? *

What would you expect from me as your coach if we decide to work together? *

Space is very limited and I want to make sure this is a good fit, why do you think you would benefit from a call or be a good addition to our team, if invited? *

On a scale of 1-5, how ready / committed are you to changing your life right now? (1 being "not ready at all" and 5 being "I'll do anything to change my life") *

1- I could put this off for awhile

2

3

4

5- I want this change now!

Select the things that you spend money on each month, that aren't helping you toward your health and fitness goals? *

Fast Food / Eating Out

Online Shopping

Nails / Hair... more than I NEED lol..

Other random stuff

How much (if you had to guess) are these costing you each month in total? *

Less than $100

$150-250/mo

$300-400/mo

$500+/mo

If we are able to come up with a plan that you feel would help you reach your goals, are you willing to give up some unnecessary expenses above so you can invest into your health? *

Yes! I am ready to make some changes so I can reach my goals

No, I'm not willing to invest into my health and future

Does your spouse or significant other support you? (Meaning they will give you a thumbs up on whatever you decide) *

Yes

No

Not Applicable

This Might Sound Like A Silly Question Because You've Made It This Far BUT, Will You Show Up On Time? (We Value Your Time, We Just Ask The Same In Return) *

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We Will Review Your Application And We Will Be In Touch For Next Steps.