1-On-1 Member Consultation Form

In order to book your 1-On-1 Consultation, you are required to complete the member information form below. Once you have completed the form hit submit and you will be taken to the booking calendar.

Required Member Information From:

1-On-1 Member Consultation

Full Name

Phone

Age

Height, (Inches)

Inches

Current Weight

Goal Weight

What are your health & fitness goals?

How motivated are you to reach this goal?

Very Motivated, I am READY!

I'm Somewhat Motivated

Only Sort of Motivated

Not Motivated

What is your biggest challenge to achieving your health & fitness goals?

Will you be in a place during our call, where you will be fully present and focused?

Are you an action taker and willing to do whatever it takes to reach your health and fitness goals?

Do you have any medical conditions, food allergies, or emotional triggers I should know about?

If we feel we are the right fit for one another and you see value in my coaching are you in a place where you're able and ready to make an investment in your health and fitness goals for your future?

Yes

I'm not sure

After hitting submit you will be able to select a date and time that is best for you for our call! Looking forward to talking to you soon!

This information remains confidential. It is not shared with anyone other than you and me. This provides me with a better understanding of you, your goals, and how I can assist you!