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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Current 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/s right now?:
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fat loss
muscle gain
strength gain
metabolism rebuild
general health
photoshoot
wedding / event
competition prep
body building off season
fertility / hormonal health
other
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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Yes
No
Unsure
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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Detail any current or past injuries:
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Have you been diagnosed or do you have any suspected medical conditions including eating disorders, PCOS or endometriosis? If so please document all relevant details:
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List all current supplements and medications (including forms of birth control):
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How consistent are you with eating 3+ meals per day?:
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very consistent
somewhat consistent
all over the place
Do you ever miss meals or fast? :
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daily
sometimes
never
List any food allergies or intolerances:
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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
Have you ever tracked and weighed your food before (e.g., MyFitnessPal)? :
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yes with ease - found it positive
yes but it was a stuggle
I have tried but not very successfully
no never
How many calories are we eating currently? (daily average):
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unsure
less than 1400
1400 - 1600
1600 - 2000
2000 - 2500
2500 - 3000
3000 - 4000
4000+
On a scale of 1–10, willingness to track your food, and follow a meal or macro plan to achieve results:
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This field is required
How are we currently eating? What phase are we currently in?:
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no set intention
maintenance
fat loss
recomp
building / surplus
What’s your biggest challenge around nutrition right now? And how long has this been a struggle?:
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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
yoga
swimming
riding
other
Current daily steps (estimate if untracked):
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How many times per week are you active or go to the gym? Detail what you do movement wise on a regualar week.:
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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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Describe your current weekly routine and context (work hours, family / personal commitments, kids, study, limitations etc.). How many hours per week can you realistically commit to training? (and when?):
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Name your occupation and describe 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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less than 5 hours
5 - 6 hours
7 - 8 hours
8 - 9 hours
9+ hours
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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low
medium
high
very high
Do you have supportive people around you who encourage your goals?:
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yes
no
somewhat
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
On a scale of 1–10, how ready are you to make an investment in yourself 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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Location: where in the world are you?:
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