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1:1 Fitness + Nutrition Coaching
Interest Form

Thank you for your interest in 1:1 coaching with me. This program features tailored workout plans, nutrition guidance, weekly check-ins, and 1-on-1 form checks. Virtual coaching is $397/month.

Please complete this form to help me understand your goals and ensure we’re a great fit to work together.

Birthday
Month
Day
Year

Double check your email for accuracy. This is how I will contact you.

Share your main objectives and what you hope to achieve. (ex. run a mile, deadlift 225, carry your kids upstairs). If the honest answer is that you want to like how you look, say that! It's a real goal and I'll program for it.

Describe and challenges or worries you have. Time, consistency, injuries, motivation dropping off three weeks in. Whatever it's actually been.

List any activities, sports, or routines you’ve tried.

How many days a week can you realistically train, and for how long?
2–3 days, 30–45 minutes
3–4 days, 45–60 minutes
4–5 days, 60+ minutes
It varies a lot week to week

Tell me about your typical meals, snacks, and routines. The real version, not the one you'd tell your doctor.

Include any relevant medical history.

Share details about any injuries. Tell me if you're working with a PT or doctor.

Are you ready to commit to being a better version of you?
Absolutely, I'm ready to start!
I'm interested but feeling a bit nervous.
Not right now — keep me on your list

Feel free to share anything else or ask questions. I'll be straight up with you.

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