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All About You Intake Form

Fill out the All About You intake form ASAP so that I can refer to your info while designing your custom training & nutrition throughout your program. The more detailed, the better!

NOTE: make sure you have your 'Before' photos taken and ready to upload.

Thank you and I look forward to chatting with you on our Onboarding Call after your intake has been submitted.

Steph

Click the button below to start.

Start

Question 1 of 32

First & Last Name:

Question 2 of 32

Email address:

Question 3 of 32

Phone Number

Question 4 of 32

Instagram username (if applicable):

Question 5 of 32

When is your ideal start date?

Progress Tracking

Please upload your "before" photos.

Include a front, back & side view. Have someone take the photos for you or use a self-timer.

Wear a bikini (women) or a short pair of shorts (men), or whatever you're comfortable in.

 

Please note: these will never be shared or posted without permission.

Question 7 of 32

Upload your front view

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Question 8 of 32

Upload your back view

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Question 9 of 32

Upload your side view

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Your Goals

We want results!

Be as detailed as possible with your goals. You don't have to limit these to fitness & nutrition. 

Fitness & nutrition are the foundation to a successful lifestyle overall - relationship success, financial success, confidence, discipline, productivity & more.

When you can define goals outside of fitness & nutrition, and understand your "why", it becomes much easier to push towards your fitness & nutrition goals!

Question 11 of 32

What are your goals and why?

Include:

1. Short term goals (2-4 weeks)

2. Medium term goals (1-12 months)

3. Long term goals (1-5+ years)

 

Ask yourself why these goals are important to you and include your answer here too.

Your Stats

Your nutrition component is largely based on your stats - like age, height, weight, activity level, etc.

 

Give me all the deets so I can calculate your custom macros!

Question 13 of 32

What is your age, height, weight?

Question 14 of 32

What is your body fat percentage? If you don't know, just reply with "I don't know."

Question 15 of 32

What do you do for a living? Are you active or sedentary at work?

Question 16 of 32

What time do you wake up?

What time do you work?

What time do you work out?

What time do you sleep?

 

Question 17 of 32

What is your ideal meal breakdown? (meal times & number of meals)

Question 18 of 32

What is your current general diet? Be as specific as possible and include your macros if you know them.

Question 19 of 32

Anything you can't or won't eat? (dislikes or allergies)

Question 20 of 32

Any supplements or medications you're using?

Question 21 of 32

If you wear a FitBit, Apple Watch or other calorie tracking device, how many calories do you burn on average daily?

Your Training

Next we will cover some details so I can design your workouts based on your schedule, experience level, athletic & aesthetic goals, equipment available & more.

Question 23 of 32

Type of training you're doing now & frequency:

Question 24 of 32

How many times per week would you like to train?

What are your ideal rest days?

Question 25 of 32

Do you have access to a full gym? If not, please list your available equipment.

Question 26 of 32

Do you have any injuries?

Emotional & Behavioral

Our thoughts & emotions directly influence our behaviors. Our behaviors play a major role in our adherence to a fitness and nutrition program.

Behavioral coaching is the third component to your program.

The next few questions will help us begin to identify any thoughts and emotions that may lead to behaviors that directly affect your success in this program.

Question 28 of 32

If you veer off course, are you more likely to:

A

Get back up & try again

B

Ask for help

C

Stay quiet & continue off course

Question 29 of 32

Can you identify any common limiting factors you find yourself experiencing that stop you from achieving your goals?

For example: no motivation, hate exercise, sweet tooth, eat junk at night, can’t contain yourself to one “cheat” meal, etc.

Question 30 of 32

If you find yourself eating emotionally (you’re not actually hungry), can you identify your triggers?

For example: boredom, stressed, having an overall bad day, habit, etc.

Question 31 of 32

What coaching style do you respond to best?

(Select all that apply)
A

Tough love and constructive criticism

B

Empathy and understanding

C

Encourage strict adherence

D

Provide motivation without constructive criticism

E

I just want someone to listen

Question 32 of 32

Include any other details that you would like me to know.

Confirm and Submit