Submit your ApplicationTraining | Advising | Coaching Client Profile Name * First Name Last Name Date of Birth * This helps us tailor the program to your specific age group. MM DD YYYY Email Address * Provide a frequently checked email. This will be your account ID. Phone Country (###) ### #### Preferred Contact Method * Email Phone Time Zone * Height * Weight * Shirt Size * Apparel included in the program. Small Medium Large XL XXL XXXL Sex * Male Female Area of Interest or Expertise * What activities or pursuits bring you the most fulfillment and satisfaction in your daily life, both professionally and personally? Occupational Analysis Occupational Specialty * Occupational Description * Briefly outline the physical requirements of your role or mission-essential tasks. Training History Previous Coaching Experience * Yes - I have worked with a coach in the past. No - I have not worked with a coach in the past. If yes, describe any prior coaching experiences, include both in-person and online. Training Experience * Novice (< 3 months) Beginner (3 to 6 months) Intermediate (6 to 18 months) Advanced (> 18 months) I am post-injury and seeking reconditioning Movement Competency * Assess your proficiency in Squats, Deadlifts, Presses, Rows, Running, and Sprinting. Minimal Basic Advanced Injury & Illness History Please detail any relevant past injuries or illnesses that might affect your training. Include dates, treatments, and current status if applicable. Lifestyle Factors * Smoke or Vape Tobacco Products Alcohol None of the above Long-range Event Calendar * Inform us of any significant upcoming events (e.g., Academy/Schools, PT Tests, Leave, etc.) that may impact your schedule. Goals & Expectations Aspirations * What do you hope to achieve with our coaching? Training Goals * Articulate your objectives with our coaching program. Expected Benefits * How do you envision our coaching helping you achieve these goals? Coaching Plan * Which plan are do you prefer to engage in? Relaxed - Monthly sessions Focused - Twice monthly sessions Intensive - Weekly sessions Nutritional Profile Daily Activity Level * Excluding exercise. Vey Light - Sitting Most of the Day Light - Mixture of Sitting, Standing and Gentle Activity Moderate - Continuous Gentle to Moderate Activity Heavy - Strenuous Activity throughout the Day Dietary Preferences * No preference Mediterranean Paleo Vegetarian Ketogenic Plant-based Average Meals per Day * 1 2 3 4 5 6 Background Information Discovery * How did you hear about us? Social Media Referral - PrepMedic Referral - Current Client Search Engine Other Motivation for Applying * What influenced your decision to apply? Commitment & Readiness Dedication Level * On a scale of 1 to 5, how would you describe your current readiness to change your behavior or adopt new practices? 1 - I can't/won't start in the next two weeks. 2 - I may be ready to start in the next two weeks. 3 - I will be ready to start in the next two weeks. 4 - I am ready to start in the next two weeks. 5 - I am already working towards my goal and want to upgrade to coaching. Additional Comments Any other information do you wish to share? Financial Commitment * I understand Online Coaching is ultimately an investment into myself therefore I am ready to commit at least $150 per month towards my goals. Thank you for your application! One of our advisors will contact you within 48-72 hours.
