Lifestyle Application | Lean Physique

lifestyle coaching application

Prospective clients interested in training are asked to submit the following application. All fields are required, but please put N/A where necessary. Please respond in enough detail so we understand your needs.

First name

Last name

Phone

City

State

Birthday

Height

Current Weight

Highest Ever Weight

List any current and recent prescriptions.

List any current and recent supplements.

List any injuries you have experienced.

Are you experiencing any current health issues?

List any prior surgeries.

What program are you interested in?

How did you hear about Coach John?

Are you familiar with gym equipment?

Are you familiar with different exercises?

Have you worked with a trainer before?

How much time do you have to commit to exercise?

On average, how many hours of sleep do you get?

Are you pregnant, trying to conceive, or breast feeding?

What's your "why?"

Please upload the following photos at full length:

Front Profile

Upload File

Side Profile

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Back Profile

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Bathing Suit or Tank Top

Upload File

By submitting this application you agree to the following:

I certify that I am providing accurate, honest and compehensive information and complete health history including medication and supplements. I understand that not providing this information may lead to health issues and may negatively affect progress.

I have read and agree to thedisclaimer.

Thanks for applying!
We’ll get back to you soon.