First Name *

Last Name *

Date of birth *

City

State *

Email *

Phone

What does a typical day look like for you right now? *

Do you currently exercise? If so, how often? *

Never

1-2x per week

3-4x per week

5+ times per week

Where do you prefer to work out? *

At home

At the gym

Both

Do you currently follow a nutrition plan or track food? *

Yes, loosely

Yes, strictly

I've tried but can't stay consistent

What are your top 1–2 fitness or health goals? *

What’s your biggest struggle when it comes to reaching your goals? *

What have you tried in the past? *

Workout programs (online or in-person)

Calorie tracking or macro counting

Diets (keto, paleo, etc.)

Personal trainer

Group classes

None / I’m new to this

What’s different this time — why now? *

On a scale of 1–10, how ready are you to commit to this process? *

I'm Not ReadyI'm All In

What kind of support do you feel you need most right now? *

Structure and consistency

Accountability

Nutrition guidance

Motivation and mindset support

Education (I want to understand the “why”)

Do you prefer direct, honest feedback or a softer approach? *

Direct + honest (just tell me what I need)

Encouraging + supportive

A blend of both

Have you ever worked with a coach before? If yes, what did you like/dislike about it? *

Are you able to dedicate 3–5 hours per week to your health right now? *

Yes

Not yet, but I want to make it work

Are you open to tracking habits, workouts, and/or food using simple tools I provide? *

Yes

I am willing to try

Do you have any injuries, health conditions, or major life circumstances I should know about? *

CBC 1:1 Coaching starts at $416/month. Are you prepared to invest in premium coaching? *

Yes, I’m ready to invest in myself

I’d like to, but I have budget concerns

No, I’m not currently in a position to invest

If we’re a good fit, how soon are you looking to get started? *

ASAP

Within 1–2 weeks

1–2 months out

Just gathering info for now

Why do you want to work with Clara specifically? *

What stood out to you about CBC? *

Thanks for applying!

We will review your responses and if it’s a fit, we'll reach out to book a quick discovery call (or move straight into onboarding)

Remember: check your inbox consistently for an email from us