Client Application
This is an application form to see if you and Samantha are a good fit for working together. Please take your time filling out this form. The more detail the better!
Email *
What is your full name? *
Age? *
Instagram Handle? *
Are you a career-driven women? *
What are your current goals? Check all that apply: *
Required
Tell me about the most important goal you’d like to accomplish in the next 3-6 months: What do you want to change about your body, your health, your mindset and your lifestyle? *
Why do you think you haven’t been successful in the past in reaching these goals? *
If you were able to reach these goals in the next 3-6 months, how would you feel? How would your life and happiness be different? *
Give me a layout of your current diet + workout routine: *
Are you currently tracking your food intake (calories and/or macros)? Have you ever tracked your food intake before? *
Coaching is an investment into your body, your health & yourself - are you ready to make that financial investment? *
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