Physical Activities Readiness Questionnaire

1
Full Name* This field is required.
First Name
Last Name
2
Date of Birth* This field is required.
Month
Day
Year
3
Email* This field is required.
example@example.com
4
I prefer to be contacted via?
Phone
Email
5
Who is supporting you with this journey you are about to start ?
Partner
Mom
Dad
No One
Other
6
Please give name and contact of your next of kin?* This field is required.
7
At what times during the day would you prefer to train?
Morning 6 am-11 am
Mid-Day 12-1500
Afternoon 1500-1700
Evening 1700-2000
8
What days are you available?
Monday
Tuesday
Wednesday
Thursday
Friday
Weekend
9
Why is your goal important to you?* This field is required.
10
Which goal fits your desire?
Loose some weight
Reduce my stress Level
Build Some Muscles
Tone my Body
Have more Energy for Life
11
My current weight make me?
Loose confidence in the way i dress
Buy clothes in bigger sizes all the time
Feel sluggish
Want to smash my Mirror
Daily movement painful
12
My ideal bodyweight will be:
13
My most pressing struggle at the moment is:
14
My most successful undertaking was when i......
15
What sports /hobby do you enjoy?
16
If you were to donate to charity of your choice,which will it be?
17
Do you have exercise routine?
18
Your current diet could be best characterized as:
low-fat
low-carb
high-protein
Vegetarian/Vegan
No special diet
19
My last full medical examination was on?
20
I can afford to pay the following.
12 Weeks Complete Online Coaching £197
12 Nutrition Coaching £95
21
What will stand in the way of your commitment in the pursuit of your worthy goals?.
Work
Family
Time
Finance
Equipments
Gym Access
22
Please list any medical condition here
23
Has your Doctor recommended you refrain from any physical activities?
YESNO
24
Agreement Form

Welcome to MB FITLIFE COACHING! I am so excited to help you achieve your goals!

By signing this Agreement, you confirm that you understand what you can expect from me, and that you agree to my expectations of you for you to be successful. The next few weeks are all about 50/50 effort between me! With each of us giving it 100%.

What You Can Expect from Me:

Action plans which are in your best interest, based upon years of trial and error. I’ve found what works after working with different ladies!
Access to a private e-portal which includes video training with useful information that will help you. You will have a 3 days workout that you can do by yourself as planned and different habits, files etc…
Access to a WhatsApp group which is where you will find different members living a similar journey to you, but also a place where you can share your daily life actions and ask questions. I will answer ALL of your questions of course.
Support, honesty, transparency and empathy: I am here for WHATEVER you need, even if you feel that it’s unrelated specifically to training or nutrition or health.
We will meet once a week, so I will make sure to show up on time.
A response time of within 2 hours from 8am-10pm, unless communicated otherwise the day before).

What I Expect From You:

I will expect you to do your check ins weekly and tell me if you’ve done what was asked in order to keep you accountable. But also, filling up your food diary through MyFitnessPal, then I can be aware about your daily eating and help you as much as I can
To show up and be on time as I will do myself.
To have OPEN COMMUNICATION with me. If something isn’t working, tell me immediately. If something is wrong, say so. Communication is key to your success!
To contribute to our Facebook community. It is there to make your road to success easier. Ask questions, participate in polls, show up for lives! Be a part of the team.
Make payments on time by ensuring you have the balance required in your payment account. If you default, you will be given 24 hours to make payment before being removed from all platforms [Portal, Facebook, etc].
Post questions to the Facebook group or through the app on the chat.
Cancellations can be approved 24h in advance, otherwise the session will be counted as done.
I am here to help and support YOU and get you results. So, show up, put in the work.

What You Can Expect From Us:

Action plans which are in your best interest, based upon years of trial and error. We’ve found what works!
Access to a private platform which includes video training with useful information that will help you.
Access to a Facebook group which is where we answer ALL of your questions.
Support, honesty, transparency and empathy: we are here for WHATEVER you need, even if you feel that it’s unrelated specifically to health, fitness, or nutrition.
A personal call each week provided your weekly Check-In Form has been filled out on time (see below).
To show up on time to your calls.
A response time of within 2 hours from 8am-10pm EST (unless communicated otherwise the day before).
______
______

What We Expect From You:

To submit your daily check-In via the document shared
To show up and be on time for each sessions planned
To cancel 24h in advance, otherwise the session will be comsumed
To be honest with me for anything going on during your journey, in order for me to help you as much as I can.

I am here to help and support YOU and get you results. So show up, put in the work.

Signing

Coach Ben
25
I AGREE TO THE ABOVE TERMS & CONDITIONS!* This field is required.
Yes
No
Should be Empty: