Get fit with us! Fill out the form below and our team will get in touch with you! Name * First Name Last Name Email * Phone (###) ### #### Gender Male Female Have you had any personal fitness training in the past? Less than 1 year 1 - 2 years 2 - 4 years 4+ years Fitness Goals Toning/sculpting muscle Fat loss Gain stamina Reduce joint pain Other If Other, please specify: Any injuries, limitations, or scraped knees I should know about? What do you hope to achieve through a health and fitness coach? How much are you willing to invest monthly in yourself / health & fitness? up to $300 $301 to $600 $601 to $1000 Do you need to discuss finances with someone before making a decision to invest in coaching? No, I make all the decisions regarding my health. Yes, they will be present at the consultation. No, I'll review my budget and chat with them before the consultation. On a scale of 1 to 10, 1 being "I just want to sit on the couch" and 10 being "I'll do whatever it takes", how committed are you to achieving your fitness goals? 1 2 3 4 5 6 7 8 9 10 What has worked well, and what have you struggled with most in your past training experience? Is there anything else not mentioned on this form that I should know about? i.e., nutritional restrictions Thank you!