Skip to content
Sign Up
Contact Us
YouTube
Instagram
Facebook
Admin
Search for:
HOME
ABOUT
COACHING
TESTIMONIALS
ARTICLES
SOCIAL MEDIA
Instagram
Youtube
CONTACT
Search for:
HOME
ABOUT
COACHING
TESTIMONIALS
ARTICLES
SOCIAL MEDIA
Instagram
Youtube
CONTACT
HOME
ABOUT
COACHING
TESTIMONIALS
ARTICLES
SOCIAL MEDIA
Instagram
Youtube
CONTACT
Transformation Form
Troy
2019-10-17T06:59:08-04:00
TRANSFORMATION COACHING
COACHING
1
PERSONAL DETAILS
2
NUTRITION DETAILS
3
MEDICAL DETAILS
4
TRAINING DETAILS
Name
*
First
Last
Phone
*
Email
*
Enter Email
Confirm Email
Date Of Birth
*
MM slash DD slash YYYY
Gender
*
Select gender
Male
Female
Height
*
Weight
*
Please describe your short & long term goals?
*
What diets and/or styles of eating have you practiced before?
*
IIFYM
Strictly Clean Eating/Meal Plan
Vegetarian
Vegan
Ketogenic
Paleo
Cheat Meals
Atkins
Weight Watchers
Other
Other diet or style of eating
*
With your current nutritional habits have you been gaining, losing or maintaining weight?
*
Gaining
Losing
Maintaining
How long have you been on your current nutritional plan?
Are you familiar with tracking Macro's?
*
Yes
No
Current Macro Breakdown
What is your current average daily caloric intake?
Carbohydrates
Protein
Fat
Which do you enjoy more, Carbs or Fats?
*
Carbs
Fats
Do you have any injuries or physical limitations?
*
No
Yes
List of any injuries or physical limitations
*
Are you currently taking any prescribed medication?
*
No
Yes
List of all current and recent prescriptions
*
Are taking any supplements?
*
Yes
No
List of all current and recent supplements
*
Do you have any history of any eating disorders or extreme dietary restriction?
*
No
Yes
Please give me as much detail as possible about your history of dieting, weight loss/regain, number of times you've tried to diet, how recently and for how long etc.
*
Please know this comes with no judgement. I only need to know for potential metabolic information to give you the best long-term results. You will never be asked to go into any detail you are not comfortable with. *
Do you have any ongoing health issues, food allergies, or intolerances?
*
No
Yes
List of health issues, food allergies, or intolerances
*
How many times per week to you strength train?
*
Select training amount
Zero
1 day/week
2 days/week
3 days/week
4 days/week
5 days/week
6 days/week
7 days/week
Training Session Duration
*
Select training amount
0-30 mins
30-60 mins
60-90 mins
90-120 mins
120-180 mins
longer
Please describe your current training protocols and fitness programs
*
How many hours of cardio do you perform on average per week?
*
What days of the week are you able to train and how long can you train?
*
What sounds worse? Eating less food or performing more cardio?
*
How active is your job?
*
Where do you workout?
*
Gym
Home
None
What equipment do you have?
*
What are your expections of me and my role as a coach?
Additional Information
How did you hear about us?
*
Website
Instagram
Youtube
Referral
Facebook
Referers Name
*
First
Last
Newsletter Subscription
Yes, please subscribe me to Colin DeWaay Training Promotions, Events & News Updates.
Phone
This field is for validation purposes and should be left unchanged.
Page load link
Go to Top
