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 low 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
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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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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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
Is there anything else your coach should know? If yes, detail:
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