Application to work with MYP
Name:
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Phone:
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Email:
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Confirm Email:
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Weight:
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Lowest weight in the last 12 months:
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Highest weight in the last 12 months:
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What is your primary goal right now? For example: Fat loss, muscle gain, strength, general health, photoshoot, wedding or event, comp prep or off season (body building):
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Does this goal include looking for a sustainable outcome and to embrace a longer term changes to our nutrition, training and lifestyle?:
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What have you tried in the past to achieve your nutrition and training goals? For example: diet or exercise protocols, previous coaching, supplement or medication use, cosmetic or medical procedures, etc.:
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Have you been diagnosed or do you have any suspected medical conditions including eating disorders, PCOS or endometriosis?:
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List all current supplements and medications (including forms of birth control):
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Detail any current or past injuries:
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How consistent are you with eating your meals?:
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very consistent
somewhat consistent
all over the place
How frequently do you eat unplanned snacks?:
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daily
sometimes
never
Do you ever miss meals or fast? :
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daily
sometimes
never
List likes and dislikes for meal choices, and allergies or intolerances. Include foods you will not eat.:
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Have you ever tracked and weighed your food before (e.g., MyFitnessPal)? If so, how did you find it?:
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How confident are you in preparing your own meals (shopping, cooking, prepping)?:
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Do you currently meal prep or plan your meals for the week?:
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weekly
sometimes
never
On a scale of 1–10, willingness to track and weigh your food, and follow a meal or macro plan to achieve results:
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This field is required
What’s your biggest challenge around nutrition right now?:
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What type of exercise or sport are you currently doing (if any)?:
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weightlifting
cardio
fitness classes
organised sports
walking
other
How many times per week are you active or go to the gym? Detail your days.:
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Have you followed a structured gym program before? :
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yes
no
not consistently
How confident are you in the gym?:
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very confident
somewhat confident
I am confident I will get there
not confident
Have you worked with a PT or coach before? If so, what did you enjoy or dislike?:
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Do you currently have a gym membership? If no, are you willing to obtain one?:
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What exercises or movements you struggle to connect well with?:
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Describe your current weekly routine (work hours, commitments, etc.). How many hours per week can you realistically commit to training? (and when?):
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What is your occupation? What level of physical activity does your occupation require?:
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Can you commit to completing a check in weekly (including photos, measurements, scale weight and mindset reflection)? If no, explain what you can currently commit to.:
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How many hours of sleep do you get on average?:
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Describe your nighttime / sleep routine (include your bedtime). Do you wake up in the night? If so, what frequency and is there a pattern.:
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How would you describe your stress levels?:
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Do you have supportive people around you who encourage your goals?:
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How confident are you in your ability to follow a nutrition and training plan consistently?:
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very confident
somewhat confident
unsure
What kind of support do you need from us as your coaches? (structure and planning, accountability, education and understanding, mindset support):
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On a scale of 1–10, how ready are you to make changes right now?:
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This field is required
Is there anything else your coach should know? If yes, detail:
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