First Name
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Last Name
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Phone
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Email
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Instagram Handle
FB Profile
Age?
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Weight?
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To confirm, you’re filling this out because you want to lose between 10-20 lbs of stubborn fat, regain energy, build lean and tone muscle, and make this the LAST COACH you’ll ever need?
Which of these best describe your goals with Stathom Fitness?
What would you expect from me as your coach if we decide to work together?
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Why is now a good time to start?
What is your current occupation and how long have you been doing it??
Do you have a significant other? If so, are they supportive of you potentially investing in your weight loss, health, and personal growth?
Were you referred by someone? If so, please drop their name so I can properly thank them! :)
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")
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1- I could put this off for awhile
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3
4
5- I want this change now!
Last Question! If you were to find a way to reach your dream body while still enjoying the foods you love and learning how to keep your results for LIFE, making Stathom Fitness the last coach you’ll ever need to hire - would you be willing (and able) to invest in getting the help necessary to get there?
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