First Name *

Last Name *

Pronouns *

Birthday *

You must be 24 years or older. We specialize in training individuals 24-50.

Time Zone *

Email *

Phone *

Current Occupation *

Short term goals *

Goals for the next 12 weeks

Long term goals *

Goals for the next 6+ months and beyond

Do you currently exercise? What’s your exercise history?

What are the barriers preventing you from reaching your goals?

What equipment do you have access to?

If none, would you be willing to invest in items like resistance bands, pull-up bar, adjustable weights, and/or a training bench?

Embarking on a new fitness journey will be challenging, but also fun and rewarding. Is this something you're physically, emotionally and financially ready to start now? *

YES, I’m ready now!

Not yet (If so, please fill this form out later when you are ready to start)

Is anyone else involved in this decision/process? Such as a partner you live with and/or share finances with? *

Yes, I have a partner I live with and/or share finances with

Nope, just me

If so, I'd love to invite them on the call. Partners listening in or participating in the consultation helps them be more understanding, supportive and in the loop. Moving toward change can impact the others around you, so strong support at home is important!

How did you find out about me?

Coach Referral

Which coach did you hear about us from?

Instagram Handle

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I consent to receive marketing messages from Beyond Binary Fitness, LLC DBA Landyn Pan Fitness, regarding special offers, fitness programs, and event announcements. Message frequency may vary, message and data rates may apply. Reply HELP for assistance, or reply STOP to opt out.