First Name

Last Name

Phone *

Date of birth

Email *

What is your main fitness goal?

What would achieving this goal mean to you?

How long have you been wanting to achieve this goal?

Never tried because I'm unsure what to do to achieve my goal

Less than 3 months

Yearsss

What are your biggest struggles right now?

Knowing what to do in the gym

Consistency in the gym

Knowing how to eat

Consistency with diet

Tell me about your main barriers that are stopping you from being consistent or starting your fitness journey? (lifestyle, work-life balance, parenting, binge-eating, stress/overwhelm, budget, time)

Are you seeing results currently?

no results

not much result, I want to speed things up!

I'm going backwards right now

Describe your current eating habits below? (If binging is an issue, what are you binging on and when, and what does your day of eating realistically look like for the whole day - breakfast, lunch, dinner, snacks, drinks)

List any injuries, medical conditions including hormonal conditions (PCOS/PMOS, endometriosis), and any medication which could affect your training or nutrition.

How soon are you looking to start?

ASAP

within 2 weeks

just exploring...

What kind of coaching are you interested in ( tick all that apply)

1:1 personal training ( st kilda or hillside only)

Online coaching

Nutrition coaching

Not sure

What level of investment are you comfortable making in your health each week?

under $30

$30-60

$60-100

$100+

This is to determine what kind of plan is suitable for you, you can subscribe to programs only on my app, or full intensive online or in person coaching. Level of service and support ranges with these options.

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