Coaching Application Form
Name:
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Surname:
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Phone:
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Email:
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Confirm Email:
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Please select which coaching service you are applying for?:
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Online Coaching (85.00 P/W)
Training Only Coaching (65.00 P/W)
Face To Face Personal Training (90-100 P/W)
If you selected Personal Training, Please choose your location.:
Doreen
Bundoora
Date Of Birth:
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Where are you from?:
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Victoria
Northern Territory
Queensland
New South Wales
Western Australia
South Australia
Tasmania
Instagram Handle (So I can follow you):
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What is your occupation? (How many days a week do you work and what are your hours, stress like etc):
Have you previously worked with a coach?:
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Yes
No
If yes, what did/didn’t work for you? :
What is your main fitness goal right now?:
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What is your training expereince?:
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Beginner - Less than 6 months of training
Intermediate - 6 months to 2 years of training
Advanced - Training for 2+ years
How many days of the gym would you like to commit to? If you're unsure I can help you decide.:
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2 Days
3 Days
4 Days
5 Days
Do you have access to a gym?:
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Yes
No
If you answered NO to the above question, what equipment do you have access to at home?:
How many steps you get per day on average? (check your phone/watch etc):
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2,000 - 5,000
5,000 - 8000
8,000 - 10,000
10,000 - 15,000
15,000+
Do you have any injuries or health issues that may impact your ability to workout?:
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Yes
No
If responded yes to above, please explain:
Do you know how to track your macros or use My Fitness Pal?:
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Have you ever been diagnosed with an eating disorder?:
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Yes
No
If responses yes to above please explain in as much detail as possible:
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Do you know how many calories you are roughly consuming per day (its ok if you don't):
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Do you take any supplements, vitamins or medications? If yes what are they?:
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Is there anything else about your diet history I should know?:
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On a scale of 1-10 (1 being not important 10 being HIGHLY important) how important is it for you to achieve your goals?:
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This field is required
Are you currently pregnant or postpartum?:
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Pregnant
Postpartum
None of the above
Please describe your current relationship with your body image?:
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Why do you feel like working with Jaymee is right for you?:
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What expectations do you have of me as your coach?:
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What are your goals where would you like to see the most improvement?:
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Do you have a time frame you would like to achieve your goals in?:
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Please list your current weight (kgs) and height (cms):
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Your preferred start date for coaching?:
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How did you hear about me?:
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Is there anything else you'd like to add?:
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Online Coaching will range from $80-$100 p/w, Are you ready to invest in your health and commit to your goals and transform your life?:
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Yes
No
Which is your preferred payment option?:
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Weekly
Fortnightly
Upfront
You Agee you have answered these questions honestly and to the best of your ability::
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Yes I Agree
What's the best way contact you?:
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Email
Instagram
Text Message
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