Application for Coaching

First Name *

Last Name *

Instagram Handle *

Phone *

Email *

Age? *

What goal are you looking to achieve? *

Weight Loss

Feminization

Masculinization

Which best describes your nutrition for the last 30 days? *

Have you been diagnosed with an eating disorder? *

What is it you are looking to gain from having a coach? *

What is the biggest hurdle you’ve been trying to overcome with your fitness? *

How much are you willing to invest on your personal fitness goals? *

$0-$100

$100-$200

$200-$300

$300+

What is your commitment level to your personal results? *

1. I’m extremely committed. I’m sick of my own bullshit, and I will do whatever it takes.

2. I’m committed enough to invest in my goals but I’m afraid of “missing out” on social events.

3. I know I need help to make a change but I’m not sure if I’m ready to fully commit.

Anything else you'd like to add before booking? *