Whitney Jude

Assistant Coach

What is your first and last name?

What is your phone number? *

What is your BEST email? *

What is your age?

What are your goals for fitness and nutrition?

Lose Weight/Body Fat

Build Muscle/Get Toned

Reduce Inflammation

Improve Long Term Health/Well Being

Gain Knowledge on Nutrition/Exercise

Other

What struggles have you experienced that have slowed down your fitness journey?

Workouts/Exercise

Nutrition

Lack of Accountability

Too Busy

Other

What have you already tried to reach these goals?

On a scale of 1-5, how ready are you to reach these goals? (1 being "Not ready at all" and 5 being "I need to make this change now")

How willing are you to invest financially in long term health and fitness goals?

Yes! I am willing to make the investment to reach my goals with both accountability and structure from a coach. this is a serious, long term change for me to reclaim my health and happiness.

I am unsure if I can financially invest, but am happy to work with you on programs/payment options so I can make a decision by the end of our call.

I am not financially stable to invest in myself or in my goals, it's not a huge priority right now.

Select the things that you spend money on each month that aren't helping towards your health and fitness goals.

Fast Food / Eating Out

Online Shopping

Nails / Hair.... more then I NEED.

Other Random Stuff

How much (if you had to guess) are these costing you each month in total?

Less than $100

$150-$250 a Month

$300-$400 a Month

$500 + a Month

If you do feel like we can help you get to your goal, would you be able to work with us on different financial options so we can make this vision come to life for you?

Sure! that would be helpful

I don't think so

Would this be a joint decision between you and your partner? If so we would love if they could join the call as well.

Yes, they play a role in this decision

No, this is 100% my decision

Be sure to be in a place where you're able to be fully present with good internet/wifi. No driving please! Sound fair?

Yes, of course

I can't guarantee anything

Do we have consent to record our call for quality purposes?

Yes

Where did you receive this application form?

Coach sent it to me