Express your interest in

Online Performance & Wellness Coaching

Getting Started

Fill out the application below
Schedule and attend your consultation
Complete your purchase
Invest your time and effort
Become an asset to your team

Client Profile

Name

First Name

Last Name

Date of Birth

This helps us tailor the program to your specific age group.

YYYY

Email Address

Provide a frequently checked email. This will be your account ID.

Phone

Country

(###)

###

####

Preferred Contact Method

Time Zone

Height

Weight

Shirt Size

Apparel included in the program.

Sex

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

If yes, describe any prior coaching experiences, include both in-person and online.

Training Experience

Movement Competency

Assess your proficiency in Squats, Deadlifts, Presses, Rows, Running, and Sprinting.

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 Intensity

I am seeking a coaching experience that is:

Relaxed / Casual

Focused / Structured

Intense / Competitive

Nutritional Profile

Daily Activity Level

Excluding exercise.

Dietary Preferences

Average Meals per Day

Background Information

Discovery

How did you hear about us?

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?

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 $300-600 per month towards my goals.