This form is
ONLY
for people who are extremely ready to change their life and do the work. This is an hands-on 1-1 program that will guide you to exactly where you want to go. If you're ready for that level of commitment, click below to apply.
First Name
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Last Name
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Email
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Phone
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Privacy Policy
What is your age?
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Instagram Handle
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What does your current fitness routine consist of, if any (days per week, exercises you do, split, etc)*
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Are you following a specific diet? If so, please give details *(if counting macros, what your macros are, how often do they change, etc.)
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Are you currently working with another coach/trainer? If so please explain your intention for looking for a new coach.
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Fast forward a year from now - where do you want to see yourself? What does your physique look like? Your life look like? How do you feel?
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A major impact on our metabolism and fitness is our work/life balance. What is your current occupation?
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What do you feel is the biggest thing holding you back from reaching your goals right now?
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If you love the plan we set up for you and feel ready for the next step, are you ready to take action right away?
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Would anyone else be involved in making a decision to take action and invest in your health with you?
Are you currently a student?
What is your intention in submitting this application to join Prime Revival?