Client Coaching Application

Complete this application honestly. Coaching is individualized and designed specifically for your goals, lifestyle, and commitment level.

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Full Name*

Age*

DOB*

Height*

Current Weight*

Goal Weight*

Phone*

Email*

Occupation*

What are your top three fitness goals?

Why are these goals important?

What has stopped you in the past?

Medical conditions, surgeries, medications, injuries or limitations

Physician approval to exercise?

Meals per day

Do you track calories/macros?

Water intake

Food allergies/restrictions

Training experience

Beginner

Intermediate

Advanced

Days per week available

Gym/equipment available

Average sleep

Stress level

Low

Moderate

High

Commitment (1-10)

Please enter a number from 1 to 10.

What usually causes you to quit?

Why do you want Roxy's Pretty Vicious Fitness as your coach?

Tell me who you are, why you're ready now, and why I should choose to coach you.

Signature*

Date*