1-on-1 Coaching Application Leave this field blank First Name Last Name What is your best contact number? Email Do you accept text messages? Yes No Do you consent for Gina to contact you via text? Yes No How old are you? How tall are you? What's your current weight? Do you have children? Yes No What are your fitness goals? On a scale of 1 to 10, how would you rate the activity level of your profession or your activity throughout the day on an average day? 1 being the least physical and 10 being the most physical. What is your WHY for completing this application? What motivates you to finally COMMIT to your goals? Have you ever followed a specific diet or workout program and if so which one(s)? Which do you prefer? Home Workouts I'm A Gym Girl What is your current workout & cardio routine - if any? Have you ever had any injuries? If so, please explain... Are you currently on any medications? If so, please list them. What is your current dietary program (if any)? Do you prefer variety in your diet or keeping it simple? Variety is the spice of life. Simple is my game. Do you like to cook and prepare your meals? Yes No Please share a sample day's diet. What are your favorite foods? Any foods you dislike or are allergic to? What have been your biggest challenges/struggles when it comes to following a fitness program? Why do you feel that NOW you are ready? Are you someone who gives up easily or is in this to WIN THIS? Yes No How did you hear about Gina and why do you think she will be able to help you step up your game? Gina is BIG on connection and loves putting a face to her applicants. Please upload a photo of your choice. Solo, family or whatever you would like to share. You have limitless potential and have EVERYTHING you need to be a success within YOU. Do you believe this? Heck yes! Not yet but I want to... I want to say HECK Yes but no 🙁 Do you want to be subscribed to my email list? Yes No
