New Client Application Name * First Name Last Name Pronouns * Birthday * You must be 24 years or older. We specialize in training individuals 24-50. MM DD YYYY Time Zone * Email * Newsletter * You’ll be opted in to my newsletter on trans and queer friendly motivation and advice on fitness, nutrition, mindset and more delivered to your inbox! You may unsubscribe at any time. Okay! Phone * (###) ### #### Current Occupation * Short term goals * Goals for the next 12 weeks Long term goals * Goals for the next 6+ months and beyond Do you currently exercise? What’s your exercise history? What are the barriers preventing you from reaching your goals? What equipment do you have access to? If none, would you be willing to invest in items like resistance bands, pull-up bar, adjustable weights, and/or a training bench? Embarking on a new fitness journey will be challenging, but also fun and rewarding. Is this something you're physically, emotionally and financially ready to start now? * YES, I’m ready now! Not yet (If so, please fill this form out later when you are ready to start) Is anyone else involved in this decision/process? Such as a partner you live with and/or share finances with? * If so, I'd love to invite them on the call. Partners listening in or participating in the consultation helps them be more understanding, supportive and in the loop. Moving toward change can impact the others around you, so strong support at home is important! Yes, I have a partner I live with and/or share finances with Nope, just me How did you find out about me? Coach Referral Which coach did you hear about us from? Landyn Dominic Anu Instagram Handle @ Thanks for submitting, we’ll be reaching out to you to schedule your free discovery call! Add coachlandyn@gmail.com to your contacts, we might end up in spam.
