Coaching Application

Tell me everything.
I'll build the plan.

Ten minutes, one form. The more honest you are here, the better your program will be.

1 · The Basics Full name * Email * Age *

Coaching is for adults 18+.

Which plan are you applying for? *

2 · Health Screen

Answer honestly — this is how I keep you safe. A "yes" doesn't disqualify you; it tells me what to work around, and whether to ask you to get a doctor's okay first.

Has a doctor ever said you have a heart condition, or that you should only do physician-recommended activity?

Yes No

Do you feel chest pain during physical activity, or have you in the past month at rest?

Yes No

Do you ever lose balance from dizziness, or lose consciousness?

Yes No

Do you have a bone, joint, or muscle problem that could be made worse by exercise?

Yes No

Are you currently taking medication for blood pressure, heart, or any chronic condition?

Yes No

Is there any other reason you know of why you should not do physical activity?

Yes No

If you answered yes to anything above — tell me more: Current or past injuries / surgeries / pain areas:

3 · Goals What's the #1 result you want? * Why now? What made you apply today? What does success look like in 6 months — specifically?

4 · Training History & Life Training experience * What are you doing right now for activity, if anything? Days per week you can realistically train * Minutes per session you can realistically give * Where will you train? *

Commercial gym Home gym Bodyweight / outdoors

List your equipment (if home / limited):

5 · Food & Recovery Describe a normal day of eating — honestly: Allergies, intolerances, or foods you won't eat: Any eating style you follow or prefer? Who cooks, and how much time do you have for food prep? Average sleep per night * Stress level lately (1 = calm, 5 = maxed out)

6 · Numbers (optional but helpful) Height Current weight Anything else I should know before building your plan?

Before you submit: Coaching is fitness and nutrition guidance from an experienced coach — it is not medical advice, and it doesn't replace your doctor. If you answered yes to any health-screen question, I may ask you to get your physician's okay before we start. By submitting, you confirm you're 18+ and agree to the terms and disclaimer.

Applications go straight to Sam. Expect a reply within 24–48 hours.

Tell me everything.I'll build the plan.

Tell me everything.
I'll build the plan.