JACKED FITNESS COACHING APP!

This application helps us make sure we’re a good fit to work together and allows us to make the most of our time on our call.

Please fill it out honestly and thoroughly.

To confirm, you are filling this out because you are looking for a coach to help you lose 5lbs+ of stubborn bodyfat, regain energy, optimize hormone & gut health, or want to tone up? *

Yes - I am serious, and want to learn more about reaching my dream body, without sacrificing my life.

No - I’m going to leave this page immediately.

Full Name *

Phone *

Email *

Please confirm your email [It's really important this is correct so that we can confirm your application + get in contact with you]

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Instagram / Facebook Handle *

Whats your age? *

Where are you currently at with your health and fitness goals? *

What is your biggest frustration right now when it comes to your body, energy, or confidence? *

What would achieving your goal actually do for you?

On a scale of 1-5, how ready / committed are you to changing your life right now? *

1 – Just browsing

2 – Curious but not committed

3 – I’m interested, but I need to figure some things out

4 – I’m ready if it’s the right fit

5 – I’m 100% ready. I’ll make it work.

What has stopped you in the past from reaching your goals? *

Are you the sole decision-maker when it comes to financial investments in your health? *

Yes

No, I consult with my partner

No, I need joint approval

Are you ready to invest significantly in your health? For context, in-person training 3–5x/week can cost $200-300/weekly—and that doesn’t include nutrition, hormones, or gut health. With me, you get full support in all areas at a fraction of the investment between $75-150/weekly. If that’s out of reach, still fill out the form—there are other ways I can help! *

Yes! I am in a position to invest in my health and fitness goals.

No, I am not in a position to invest in my health and fitness goals.

Possibly, if this is the right fit and we can figure out a payment plan that fits my needs!

What is your realistic monthly budget for investing in your health right now? *

Less than $100

$100–$300

$300–$500

$500+

(This helps us match you with the right program and options.)

Anything else you'd like to share that would help us understand your goals, situation, or what you’re looking for in a coach/program? *

By submitting this application, you’re saying you’re serious about your results — not just wasting your time or ours. We’re not here to babysit. Are you cool with that?

Hell yes

Actually, I’m not serious