SECTION 1 — BASIC INFORMATION

Full Name

Email Address

Instagram Username

Time Zone *

SECTION 2 — CURRENT SITUATION

What best describes you right now?

3 Days

4 Days

5 Days

6 Days

7 Days

How would you describe your current fitness level?

Morning

Afternoon

Evening

Late Night

What is your biggest challenge right now?

Building muscle

Increasing strength

Energy & consistency

Structure & accountability

SECTION 3 — GOALS

What is your primary goal over the next 12 weeks?

Why is this goal important to you right now?

SECTION 4 — COMMITMENT

How serious are you about improving your health and performance right now?

Any movements that currently cause pain or discomfort?

How many days per week can you realistically train?

Yes

No

Not Sure / Need Medical Clearance

SECTION 5 — COACHING INVESTMENT

Professional coaching requires commitment of both time and financial investment.

If the program feels like the right fit, how much would you be comfortable investing in coaching?

$300 – $500

$500 – $1,000

$1,000 – $2,000

$2,000+

Why do you feel you would be a good fit for The Wade Method coaching?

Are you open to a short call to see if this program is the right fit?

Yes

No

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