Sheena Fitness Coaching - Initial Consultation

Please complete this short form below to provide a better understanding of your goals and what's holding you back from them. Once completed, you'll receive an email from us to book in your complimentary dream body call.

What is your goal and why is it important to you? *

What motivates you towards this goal? *

Please fill in your details below, so we can also send you our free dream body meal prep guide.

Full Name *

Phone *

Date of birth *

Email *

Instagram Handle *

Please fill in these important details as we need to know if we need another qualified professional from our team to help you achieve your dream body.

Height *

Weight *

Medical History - Do you have and/or suffer from any of the following conditions?

Heart trouble

Pain in chest

Faint or dizzy spells

High blood pressure

Arthritis

Asthma

Bone or joint issues

Back problems

Epilepsy

Sports injury

Depression

Other

Are you pregnant? *

Are you currently taking any medications or supplements? *

Yes

No

Have you had a blood test within the last 12 months? *

Yes

No

What is your job/occupation? *

Do you consume or do any of the following often? *

Smoking

Alcohol

Order fast food

What's your fitness level and nutrition knowledge like? *

What's your mindset and stress like right now? *

Are there any lifestyle habits that we should know about that impacts your health and fitness goals? *

Does your partner support your fitness goals and does their lifestyle impact you to achieve your goals? *

Do any of these resonate with you? (Select as many as you need.) *

Lacking confidence

Intimidated by the gym

Body insecurities

Feeling burned out

Negative self-talk

Poor sleep

Binge eating

Low mood

Rarely drink water

What results do you wish to achieve? (Select as many as you want.) *

Reduced body fat

Tone and shape

Build muscle

Increase stamina

Improve stamina

Improve flexibility

Rehabilitation

Reduced stress

Improved sleep

Where do you want to see change on your body? (Select as many as you want.) *

Thighs

Glutes

Stomach

Chest

Arms

Shoulders

Back

Calves

Lower back

Hips

Waist

How would you feel if you could achieve this goal? *

How would you feel if you didn't achieve this goal? *

Why haven't you achieved this goal in the past? *

What are you going to do differently this time to achieve your goal? *

What are you expecting from my coaching & services? *

If we were sitting here having this conversation 12 weeks from now and we were looking back over the last 12 weeks, what needs to happen for you to be happy with the results? *

How many times a week do you want to train towards achieving this goal? *

Please answer the following questions truthfully.

I'm prepared to modify my lifestyle habits and nutrition intake. *

Yes

No

I’m prepared to track my food intake or follow a meal plan. *

Yes

No

I’m prepared to send progress pictures and measurements. *

Yes

No

I’m prepared to fill in my training app stats every week. *

Yes

No

How did you hear about us? *

Is there any additional information which would be useful in helping you achieve your goals?

Signature *

Clear

Date *

By providing my details, I agree to receive text messages and emails from Sheena Fitness Coaching. We promise not to spam you!