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Full Name
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Email
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Phone
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Instagram Handle
What goal are you most focused on right now? (Select all that apply)
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Weight loss
Fat loss and body recomposition
Strength and muscle development
Consistency with workouts and nutrition
Body confidence and appearance
A sustainable routine that fits my lifestyle
Higher daily energy and overall well-being
Why does your goal matter to you? (Select all that apply)
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I want to feel strong, sexy and empowered
I don’t feel like myself in my body anymore, and it’s affecting my confidence
I know what to do, but I’m not doing it consistently
I’m tired of relying on motivation instead of having a routine that works
I want to break free from all-or-nothing habits and finally feel in control
I want to improve my health for the long run
I’m doing this to show up better for my family or loved ones
I want support and accountability instead of trying to do this alone
What have you already tried to reach this goal? (Select all that apply)
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Worked with a coach or trainer
Followed a fitness app or home workout program
Joined a gym but couldn’t stay consistent
Followed a restrictive diet (keto, fasting, paleo, etc.)
Took supplements or fat burners
Tried random Instagram/YouTube workouts
Didn’t have a clear plan or accountability
On a scale of 1–5, how serious are you about achieving your goal right now?
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5 being the most serious
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2
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5
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What has actually been getting in the way of consistency for you? (Select all that apply)
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I don’t have a clear structure or routine to follow
I don’t have a plan I trust or know how to follow
I don’t have accountability to stay on track
I’m unsure how to eat in a way that supports my goals
I struggle to make time when work or life gets busy
I hesitate to fully commit because I’m afraid of failing again
If you followed through and reached your goal, what would that make possible for you? (Select all that apply)
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I’d feel proud of myself for finally doing something I said I would
I’d stop carrying the quiet disappointment I feel about not taking action on my goals
I’d trust myself again in other areas of my life
I’d feel more present and comfortable in everyday moments
I’d stop putting parts of my life on hold because of how I feel in my body
I’d feel like I’m taking care of myself instead of always putting myself last
If we decide this is a good fit, what level of monthly investment feels realistic for you? (Select one)
$450–$550
$550–$750
I’m ready to invest in myself, finances aren't the issue
I’m not in a position to invest in coaching right now
Is there anything else you’d like me to know before your call? Or any questions you’d like to ask?
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Who else, besides yourself, will be involved in making decisions about your fitness journey?
Why does this time to commit to your goals feel different for you—and what are you prepared to do differently?
Is there anything else you’d like me to know before your call? Or any questions you’d like to ask?
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