Consultation Form – Vicki D Fitness Therapy

Online Training Questionnaire

WELCOME! Please the form below in order to apply for the opportunity to become a one-on-one coaching client with me!

First Name

Last Name

Age

Phone Number

What method(s) of communication do you prefer? (Check all that apply)

Email Text Phone Call

Instagram Handle

What are your goals? (Check All that Apply)

Fat loss Muscle Building Strength Building Lifestyle & Mindset Change

What is the #1 goal you would like to accomplish in the next 6-12 weeks? What do you want to change about your body, your mind, and your lifestyle?

What's the reason you haven't been successful in the past with your goals?

If I was able to help you reach these goals, how would you feel 3 months from now? How would your life and happiness change?

Give me a layout of your current diet & workout situation. Are you tracking macros/calories? Are you on a specific workout plan, or are you working out at all?

My coaching packages start at a few hundred dollars a month. If we both feel like it's an absolute YES to work together, are you able to put down the financial investment required to hire a coach?

LET'S DO IT! Maybe in the future.